What Is Sepsis?
Sepsis is a condition in which the immune system over-responds to an infection somewhere in the body. The normal infection-fighting processes, which include the release of chemicals into the bloodstream to fight the infection, are exaggerated, causing severe inflammation throughout the body. In essence, the immune system attacks its own tissues, causing organ damage, organ failure and sometimes death if not promptly treated.
Sepsis is quite common, particularly in people who are or have recently been hospitalized in an intensive care unit. It can occur in people of all ages but children and older adults are at highest risk. Other medical conditions such as cancer, diabetes, immune disorders and lung disease may also raise the risk of sepsis. Sepsis is a medical emergency – one person dies from it every 3 seconds worldwide. Early diagnosis and treatment can often save lives.
Sepsis is a medical emergency. If you have an infection or wound that isn’t responding to treatment and are experiencing symptoms such as rapid heartbeat or trouble breathing, seek immediate medical care or call 9-1-1.
What Causes Sepsis?
Sepsis always develops as a result of an infection somewhere in the body. The infection can be bacterial, viral or fungal but bacteria are the most common cause of infections that lead to sepsis. Hospitalized patients may be more likely to develop bacterial infections when certain medical devices are used, such as blood vessel or urinary catheters, which can inadvertently introduce bacteria into the bloodstream. Sepsis is not a contagious condition – you can’t “catch” it from another person.
Signs and Symptoms of Sepsis
Patients with an active or recent infection should be closely monitored for early signs of sepsis, which may include one or more of the following:
- Abnormally high or low body temperature
- Rapid heart and breathing rates
- Low blood pressure
- Pale, cool arms and legs
Symptoms may be mild at first and then quickly get worse if the sepsis progresses. Untreated, sepsis can progress and begin to cause severe organ damage, at which time additional symptoms will present and may include:
- Difficulty breathing
- Low or no urine output
- Abnormal liver tests
- Changes in mental status
Nearly all patients with severe sepsis require treatment in the hospital and some may require care in the intensive care unit (ICU). Unless early, aggressive treatment is given, severe sepsis can lead to septic shock – a condition that is diagnosed when the blood pressure drops to dangerous levels. This drop in blood pressure disrupts the body’s functions at a cellular level and greatly increases the risk of death.
Early diagnosis of sepsis is essential to help improve the chances of a good outcome. However, some of the early symptoms can mimic other health problems, which can make it difficult to diagnose in the early stages.
If you have had a recent infection and have one or more of the symptoms associated with sepsis, your doctor may do the following to confirm or rule out a diagnosis of sepsis:
- Take a complete medical and family history
- Perform a comprehensive physical exam
- Ask you about all your symptoms
- Order urine tests to look for signs of infection and check kidney function
- Order blood tests to look for signs of infection in your blood
- Order imaging tests to help locate the site of infection
Confirmed Sepsis Requires Aggressive Treatment
If sepsis is confirmed, patients will usually be cared for in the hospital and often in the intensive care unit of a hospital. This is because this condition can quickly worsen and become life-threatening. Very close monitoring of the patient’s vital signs and symptoms is required and treatments will often be adjusted based on the patient’s response. Blood and urine will also be tested frequently.
The first line of treatment will be to address the infection that is causing the sepsis. Broad spectrum antibiotics will be given immediately and tests will be conducted to try to identify the specific bacteria that is causing the infection so that a more targeted antibiotic can be administered.
Additional treatments will be given as needed and may include:
- Supplemental oxygen
- Intravenous fluids
- Medications to raise the blood pressure
- A breathing tube and a ventilator (if you have trouble breathing)
- Dialysis, in case of kidney failure
- Insulin to keep blood sugars in the optimal range, even in you don't have a history of diabetes
- Drainage of abscesses (pockets of infection)
- Surgical removal of the infected part of the body
Most people with mild sepsis who receive prompt, aggressive treatment will fully recover. However, if mild symptoms progress to severe sepsis or septic shock, the prognosis is less optimistic. Some people may sustain permanent tissue and/or organ damage and some people will die. For this reason, it is essential to seek immediate medical help if sepsis is suspected.