Sepsis

Written by Krista O'Connell | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What Is Sepsis?

Sepsis is a life-threatening complication of infection. It often occurs in people who are elderly or have weak immune systems.

Sepsis happens when the body suffers from an infection and the chemicals released into the blood to fight the infection cause inflammation over the entire body. Severe cases of sepsis can lead to septic shock. Septic shock occurs when the inflammation causes tiny blood clots to form, blocking oxygen from vital organs and leading to organ failure and a life-threatening drop in blood pressure.

Sepsis and septic shock affect millions of people around the world and kill more than one in four people who contract it (Dellinger, 2007).

What Are the Symptoms of Sepsis?

Doctors have identified three stages of sepsis: sepsis, severe sepsis, and septic shock. Sepsis often occurs while people are still in the hospital recovering from a procedure, however this is not always the case. If you experience any of the symptoms below, seek medical attention immediately. The earlier treatment with antibiotics and heavy amounts of IV fluids is started, the greater a person’s chance for survival.

Sepsis

Symptoms of sepsis include:

  • fever above 101.3 F
  • heart rate higher than 90 beats a minute
  • breathing rate higher than 20 breaths a minute
  • possible or definite infection

For a doctor to diagnose sepsis, two of these symptoms must be present.

Severe Sepsis

Symptoms of severe sepsis, which can mean organ dysfunction, require that only one of the following signs be present:

  • patches of discolored skin
  • noticeably lower amounts of urination
  • mental ability changes
  • low platelet (blood clotting cells) count
  • problems breathing
  • abnormal heart functions
  • chills due to fall in body temperature
  • unconsciousness
  • extreme weakness

Septic Shock

Symptoms of septic shock include:

  • any of the symptoms of severe sepsis are present
  • cold skin
  • very low blood pressure

The Serious Effects of Sepsis

The following can occur as a result of sepsis:

  • impaired blood flow to brain, ear, or kidneys
  • blood clot formation in organs, arms, legs, fingers, or toes
  • organ failure
  • tissue death (gangrene)

What Causes Sepsis?

Sepsis can be cause by any type of infection—bacterial, fungal, or viral. However, the following types of infections are more likely to cause sepsis than others:

  • pneumonia
  • abdominal infection
  • kidney infection
  • bloodstream infection

According to the Mayo Clinic, sepsis is on the rise in the United States (Mayo Clinic). Possible reasons for this include:

  • aging populations
  • increase in drug-resistant bacteria
  • large number of people with immune systems weakened because of HIV and cancer treatments

Who Is at Risk for Sepsis?

People at high risk of developing sepsis include:

  • the very young and very old
  • people with weak immune systems
  • ICU patients that are already very sick
  • patients exposed to invasive devices (such as intravenous catheters or breathing tubes)

How is Sepsis Diagnosed?

If you have symptoms of sepsis, your doctor will perform certain tests to make a diagnosis and determine the severity of your infection.

One of the first and easiest tests is a blood test. Your blood will be tested to see if there are any of the following complications present:

  • infection
  • problems clotting
  • abnormal liver or kidney function
  • decreased amount of oxygen
  • electrolyte imbalance (electrolytes are minerals that affect the amount of water in your body as well as the acidity of your blood)

Depending on your symptoms and the results of a blood test, other tests may be ordered, including:

  • urine test (to see if bacteria are present)
  • wound secretion test (if you have an open wound that looks infected)
  • mucus secretion test (to see what type of germ is behind the infection)

In cases where the source of the infection is not clear from the tests above, a doctor might want to get an internal view of your body using one of the following:

  • X-rays to view the lungs
  • CT scans (also called computed tomography) to view possible infections in the appendix, pancreas, or bowel area
  • ultrasounds to view infections in the gallbladder or ovaries
  • MRI, which can identify soft tissue infections

How Is Sepsis Treated?

Sepsis can progress to septic shock and death if it is not treated quickly. The earlier sepsis is diagnosed and treated, the more likely you are to survive. Doctors use a number of medications to treat sepsis, including:

  • antibiotics via IV (to fight infection)
  • vasoactive medications (to help to increase blood pressure)
  • insulin (for blood sugar stability)
  • corticosteroids (to help with inflammation)
  • painkillers

Severe sepsis cases may also require large amounts of IV fluids and a respirator for breathing. If the kidneys are affected due to sepsis, dialysis might also be necessary. Kidneys help filter harmful wastes, salt, and excess water from the blood. In dialysis, a machine performs these functions.

In some cases, surgery may be needed to remove a source of infection, such as draining a pus-filled abscess or removing infected tissue.

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