Sepsis develops when an existing infection triggers an extreme immune system response in your body.
When you experience an infection, your immune system responds by releasing proteins and other chemicals to fight it. Sepsis occurs when this response gets out of control, triggering extensive inflammation.
Most infections that cause sepsis are bacterial. But other infections — including COVID-19, influenza, and fungal infections — can also lead to sepsis.
Sepsis causes fever, a rapid heart rate, and difficulty in breathing, among other symptoms. It’s a serious condition that requires swift medical treatment.
Severe sepsis can lead to septic shock, a medical emergency. Septic shock is associated with a significant drop in blood pressure, organ failure, and widespread tissue damage. If left untreated, it can be fatal.
Severe sepsis is when the infection and inflammation is severe enough to start affecting organ function. Septic shock is a severe complication of sepsis that causes a significant drop in blood pressure. This can lead to many serious complications including: organ dysfunction, respiratory or heart failure, stroke and possible death
While sepsis often occurs in hospital settings, it can also happen in other locations. In some cases, you might not even know you have an infection that could potentially lead to sepsis.
What are the symptoms of sepsis?
It’s important to seek immediate medical attention if you have any symptoms of sepsis. The earlier you seek treatment, the greater chance you have of recovering. Symptoms of sepsis can include: fever and/or chills, confusion or disorientation, difficulty breathing, fast heart rate or low blood pressure (hypotension), extreme pain, and sweaty skin.
It’s possible to mistake the symptoms above for those of another condition, like pneumonia, COVID-19, or cancer.
In addition, sepsis symptoms can be particularly hard to identify in infants, children, and people with: communication challenges, learning disabilities and dementia. It’s best to seek medical assistance right away if you suspect sepsis. A health professional can examine you or the person you care for to make a diagnosis.
Signs and symptoms of severe sepsis
Severe sepsis is characterized by organ failure. You must have one or more of the following signs to be diagnosed with severe sepsis: difficulty breathing, bluish discoloration of the skin, especially lips, fingers, toes; chills due to a drop in body temperature, decreased urination, dizziness, changes in mental ability, extreme weakness (asthenia), low platelet count (thrombocytopenia) abnormal heart functions, unconsciousness
Signs and symptoms of septic shock (septicemia)
Sepsis can advance very quickly to severe sepsis and septic shock. As it transitions, it becomes more life-threatening.
Some severe sepsis and septic shock symptoms can overlap, like severe difficulty breathing, acute confusion, and bluish skin. Another key symptom of septic shock is very low blood pressure.
What causes sepsis?
Any infection can trigger sepsis, but the following types of infections have a higher risk of causing sepsis: pneumonia, abdominal infections, kidney infections, blood poisoning.
According to the National Institute of General Medical Sciences, the number of sepsis cases in the United States increases every year. Possible reasons for the increase include: an aging population, due to the fact that sepsis is more common in seniors, an increase in antibiotic resistance, which happens when an antibiotic medication loses its ability to resist or kill bacteria, an increase in the number of people with illnesses that weaken their immune systems.
Who is at risk for sepsis?
Although some people have a higher risk of infection, anyone can get sepsis. People who are at the highest risk include: young children and seniors people with weaker immune systems, including people with HIV or those undergoing chemotherapy treatment for cancer, people in intensive care units (ICUs) people exposed to invasive devices, like intravenous catheters or breathing tubes.
Newborns and sepsis
Neonatal sepsis occurs when a baby gets a blood infection within the first month of life. Neonatal sepsis is classified based on the timing of the infection, according to whether the infection was contracted during birth (early-onset) or after birth (late-onset). This helps the doctor decide what kind of treatment to administer. Low birth weight and premature babies are more susceptible to late-onset sepsis because their immune systems are immature. While symptoms can be subtle and nonspecific, some signs include: listlessness, not breastfeeding/feeding well, low body temperature, apnea (gaps in breathing), fever, pale color, poor skin circulation with cool extremities, abdominal swelling, vomiting, diarrhea, seizures, jitteriness, yellowing of the skin and whites of the eyes (jaundice).
Neonatal sepsis is still a leading cause of infant death. With early diagnosis and treatment, most babies can recover completely and have no other problems. In addition, universal maternal screening and proper neonatal testing have significantly reduced the risk of neonatal sepsis.
Seniors and sepsis
The immune system tends to weaken with age. According to a 2017 review, around 40 to 50 percent of all bacteremia cases occur in older adults, which can lead to sepsis.
But age isn’t the only factor that puts seniors at an increased risk. Older adults are also more likely to have existing chronic illnesses, like diabetes, kidney disease, cancer, or high blood pressure. Other risk factors pertinent to seniors include increased use of medication, malnutrition, and imbalances in intestinal microbiota.
Older adults can contract sepsis from common infections, like pneumonia or urinary tract infections (UTIs). Infections from pressure sores can also lead to sepsis.
Finally, sepsis symptoms like confusion and disorientation may be particularly difficult to identify in older adults with dementia.
How is sepsis diagnosed?
If you have sepsis symptoms, your doctor will order tests to diagnose and determine the severity of your infection. One of the first tests is a blood test. Your blood is checked for complications like: infection, clotting problems, abnormal liver or kidney function, decreased amount of oxygen, an electrolyte imbalance, which affects the amount of water in your body and the acidity of your blood.
Depending on your symptoms and the results of your blood test, your doctor may order other tests, including: a urine test (to check for bacteria in your urine), a wound secretion test (to check an open wound for an infection), a mucus secretion test (to identify germs responsible for an infection).
If your doctor can’t determine the source of infection using the above tests, they may order an internal view of your body using one of the following: chest x-rays to view the lungs, CT scans to view possible infections in the appendix, pancreas, or bowel areas, ultrasounds to view infections in the gallbladder or ovaries, MRI scans, which can identify soft tissue infections.
Sepsis criteria
There are two sets of criteria doctors use to determine the severity of sepsis. One set of criteria is for systemic inflammatory response syndrome (SIRS). SIRS is defined when you meet two or more of the following criteria: a fever of more than 100.4°F (38°C) or less than 96.8°F (36°C), a heart rate of more than 90 beats per minute, a respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO2) of less than 32 millimeters of mercury (mm Hg), an abnormal white blood cell count.
Another tool is the quick sequential organ failure assessment (qSOFA). It uses the results of three criteria: low blood pressure reading (systolic blood pressure of less than 100 mm Hg), high respiratory rate (greater than 22 breaths per minute), Glasgow coma scale score of 14 or less to determine your level of consciousness. A positive qSOFA occurs when two or more of the above measurements are abnormal. Some physicians prefer using qSOFA because, unlike the SIRS criteria, qSOFA doesn’t require laboratory tests. The results of either of these assessments will help your doctor determine the best course of treatment.
How is sepsis treated?
Sepsis can quickly progress to septic shock and death if it’s left untreated. Doctors use a number of medications to treat sepsis, including: intravenous (IV) antibiotics to fight the infection, medications to increase blood pressure, insulin to stabilize blood sugar, corticosteroids to reduce inflammation, pain relievers to help with discomfort. Severe sepsis may also require large amounts of IV fluids and a respirator for breathing. Dialysis might be necessary if the kidneys are affected.
Your kidneys help filter harmful wastes, salt, and excess water from your blood. With dialysis, a machine performs these functions.
In some cases, surgery may be needed to remove the source of an infection. This may include draining a pus-filled abscess or removing infected tissue. Treatment options may vary slightly for older adults, depending on their risk factors. According to a 2016 review, older adults may be more sensitive to medications that increase blood pressure and antibiotics.
Additionally, seniors are more likely to develop delirium in the ICU and should be regularly screened for sepsis symptoms.
Is sepsis contagious?
Sepsis isn’t contagious. But the pathogens responsible for the original infection, like viral pneumonia or COVID-19, can be contagious. Sepsis spreads within a person’s body from the original source of infection to other organs through the bloodstream.
Recovery from sepsis
Recovering from sepsis depends on the severity of your condition and any pre-existing health issues you might have. While many people make a full recovery, others report lasting effects. The UK Sepsis Trust reports that it can take up to 18 months before people who’ve had sepsis start feeling like their usual selves again.
According to the Sepsis Alliance, around 50 percent of sepsis survivors deal with a condition called post-sepsis syndrome (PSS). This condition includes long-term effects like: damaged organs, insomnia, nightmares, disabling muscle and joint pains, fatigue, poor concentration, lowered cognitive functioning, lowered self-esteem.
Sepsis prevention
You can reduce your risk of sepsis by preventing the spread of infection. In the current COVID-19 pandemic, this is more important than ever.
Severe COVID-19 infections cause symptoms similar to sepsis. In addition, contracting COVID-19 puts you at an increased risk of developing another infection. A 2021 review reported that up to 17 percent of people admitted to the ICU with COVID-19 had additional infections. You can help prevent both COVID-19 and other infections by taking the following precautions: Stay up to date on your vaccinations. Get vaccinated for COVID-19, the flu, pneumonia, and other common infections. Keep your distance from people outside your household. Avoid non-essential travel and activities, and stay 6 feet away from people you don’t know. Wear a mask. Masks help protect you and others from respiratory infections. Wear a mask in indoor public spaces, like grocery stores and movie theaters. Practice good hygiene. This means practicing proper wound care, hand-washing, and bathing regularly. Get immediate care if you develop signs of infection. Every minute counts when it comes to sepsis treatment. The sooner you get treatment, the better the outcome.
source@healthline
