Sepsis

 Symptoms
 Effects
 Causes
 Risks
 New-borns
 Seniors
 Spreading
 Diagnosis
 Criteria
 Treatment
 Recovery
 Prevention
 Outlook

What is sepsis?
Sepsis is a life-threatening illness caused by your body’s response to an infection. Your
immune system protects you from many illnesses and infections, but it’s also possible for it to go into overdrive in
response to an infection.

Sepsis develops when the chemicals the immune system releases into the bloodstream to
fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic
shock, which is a medical emergency.

There are more than 1.5 million cases of sepsis each year, according to the Centres for
Disease Control and Prevention (CDC)Trusted Source. This type of infection kills more than 250,000 Americans a
year.

What are the symptoms of sepsis?

There are three stages of sepsis: sepsis, severe sepsis, and septic shock. Sepsis can happen
while you’re still in the hospital recovering from a procedure, but this isn’t always the case.

It’s important to seek immediate medical attention if you have any of the below symptoms.
The earlier you seek treatment, the greater your chances of survival.

Sepsis
Symptoms of sepsis include:

 a fever above 101ºF (38ºC) or a temperature below 96.8ºF (36ºC)

 heart rate higher than 90 beats per minute
 breathing rate higher than 20 breaths per minute
 probable or confirmed infection
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 You must have two of these symptoms before a doctor can diagnose sepsis.

Severe sepsis
Severe sepsis occurs when there’s organ failure. You must have one or more of the
following signs to be diagnosed with severe sepsis:

 patches of discoloured skin

 decreased urination
 changes in mental ability
 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 the symptoms of severe sepsis, plus a very low blood
pressure.

The serious effects of sepsis

Although sepsis is potentially life-threatening, the illness ranges from mild to severe.
There’s a higher rate of recovery in mild cases.

Septic shock has close to a 50 percent mortality rate, according to the Mayo Clinic. Having
a case of severe sepsis increases your risk of a future infection.

Severe sepsis or septic shock can also cause complications. Small blood clots can form
throughout your body. These clots block the flow of blood and oxygen to vital organs and other parts of your body.
This increases the risk of organ failure and tissue death (gangrene).

What causes sepsis?

Any infection can trigger sepsis, but the following types of infections are more likely to
cause sepsis:

 pneumonia
 abdominal infection
 kidney infection
 bloodstream infection

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, because sepsis is more common in seniors

 an increase in antibiotic resistance, which happens when an antibiotic loses its
ability to resist or kill bacteria

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  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 risk include:

 young children and seniors

 people with weaker immune systems, such as those with HIV or those in
chemotherapy treatment for cancer
 people being treated in an intensive care unit (ICU)
 people exposed to invasive devices, such as intravenous catheters or breathing
tubes

New-borns and sepsis

Neonatal sepsis is when your 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 the birth process (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 well
 low body temperature
 apnea (temporary stopping of breathing)
 fever
 pale colour
 poor skin circulation with cool extremities
 abdominal swelling
 vomiting
 diarrhoea
 seizures
 jitteriness
 yellowing of the skin and whites of the eyes (jaundice)
 problems feeding

Neonatal sepsis is still a leading cause of infant death, but with early diagnosis and
treatment, the baby will recover completely and have no other problems. With maternal universal screening and
proper neonatal testing, the risk of neonatal sepsis has decreased significantly.

Seniors and sepsis

Since our immune system weakens as we age, seniors can be at risk for sepsis. In one 2006
studyTrusted Source, people over the age of 65 made up nearly 70 percent of sepsis cases.

In addition, chronic illness, such as diabetes, kidney disease, cancer, high blood pressure,
and HIV, are commonly found with those who have sepsis. The most common types of infections to cause sepsis in
seniors are respiratory like pneumonia or genitourinary like a urinary tract infection.
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 Other infections can come with infected skin due to pressure sores or skin tearing. While
these infections might not be noticed for a while, confusion or disorientation is a common symptom to look for
when identifying an infection in seniors.

Is sepsis contagious?
Sepsis isn’t contagious. However, the pathogens that caused the original infection that lead
to sepsis can be contagious. Sepsis spreads within a person’s body from the original source of infection to other
organs through the bloodstream.

How is sepsis diagnosed?

If you have symptoms of sepsis, your doctor will order tests to make a diagnosis 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 imbalance in minerals called electrolytes 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 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 an infection using the above tests, they may
order an internal view of your body using one of the following:

 X-rays to view the lungs

 CT scans to view possible infections in the appendix, pancreas, or bowel area
 ultrasounds to view infections in the gallbladder or ovaries
 MRI scans, which can identify soft tissue infections

Sepsis criteria
There are two tools, or sets of criteria, doctors use to determine the severity of your
condition. One is the systemic inflammatory response syndrome (SIRS). SIRS is defined when you meet two or
more of the following criteria:

 fever of more than 100.4°F (38°C) or less than 96.8°F (36°C)

 heart rate of more than 90 beats per minute
 respiratory rate of more than 20 breaths per minute or arterial carbon dioxide
tension (PaCO2) of less than 32 mm Hg
 abnormal white blood cell count

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 Another tool is the quick sequential organ failure assessment (qSOFA). It uses the results of
three criteria:

 low blood pressure reading

 high respiratory rate (greater than 22 breaths per minute)
 Glasgow coma scale score of less than 15 (This scale is used to determine your
level of consciousness.)

A positive qSOFA is determined if 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 care.

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:

 antibiotics via IV to fight infection

 vasoactive medications to increase blood pressure
 insulin to stabilize blood sugar
 corticosteroids to reduce inflammation
 painkillers

Severe sepsis may also require large amounts of IV fluids and a respirator for breathing.
Dialysis might be necessary if the kidneys are affected. 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 the source of an infection. This includes
draining a pus-filled abscess or removing infected tissue.

Can you recover from sepsis?

Your recovery from sepsis depends on the severity of your condition and any pre-existing
conditions you might have. Many people who survive will recover completely. However, others will report lasting
effects.

The UK Sepsis Trust says it can take up to 18 months before survivors start to feel like
their normal self. The Sepsis Alliance says that around 50 percent of sepsis survivors deal with post-sepsis
syndrome (PSS). The alliance says this condition includes long-term effects such as:

 damaged organs
 insomnia
 nightmares
 disabling muscle and joint pains
 fatigue
 poor concentration
 lowered cognitive functioning
 lowered self-esteem

Severe cases of sepsis can lead to death.

Sepsis prevention
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 Taking steps to prevent the spread of infection can reduce your risk of developing sepsis.
These include:

 Staying up to date on your vaccinations. Get vaccinated for the flu, pneumonia, and
other infections.
 Practicing good hygiene. This means practicing proper wound care, handwashing,
and bathing regularly.
 Getting 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.

Outlook
It’s important to remember that sepsis is a medical emergency. Every minute and hour
counts, especially since the infection can spread quickly. There’s no one symptom of sepsis, but rather it has a
combination of symptoms.

Get immediate medical attention if you suspect that you have sepsis, especially if you have
a known infection.