What is sepsis?
Sepsis is an extreme and overwhelming response to an infection anywhere in the body. The organisms that caused the serious infection stimulate the release of substances into the blood that cause widespread inflammation. This quickly leads to organ damage, organ failure, or even death.
There is often a lot of confusion about sepsis due to some related terms that people sometimes use interchangeably. However, they each mean something slightly different. Here is a look at these terms:
- Sepsis is an extreme response to an infection somewhere in the body, which leads to organ problems. It is possible to have organ problems from sepsis and not know you have an infection. Doctors should consider sepsis as a potential cause for new organ problems.
- Bacteremia: the presence of bacteria in the blood. This is mainly a lab finding. A healthy immune system normally clears the body of small amounts of bacteria introduced into the bloodstream. But under some circumstances, bacteria in the blood can begin an active infection that can spread throughout the body and organs. Bacteremia can also lead to sepsis.
- Septicemia is a term some providers may still use to describe a widespread blood infection, blood poisoning, or a bloodstream infection. Bacteria are present, multiplying and spreading in the blood. In fact, septicemia is a narrow term that muddles the discussion and critical nature of sepsis. People incorrectly use the term septicemia in place of sepsis.
The truth is sepsis can occur without bacteria or other detectable microorganisms in the blood. Also, infection anywhere in the body can trigger sepsis.
Sepsis is one of the leading causes of hospital readmissions and hospital-related deaths. Every year, more than a million Americans suffer from sepsis. It can kill 10 to 30% of those affected. The most severe form—septic shock—kills up to 50% of people who develop it. Sepsis is especially dangerous for the elderly, the very young, and people with chronic medical conditions. People who survive it can also develop post-sepsis syndrome, which is characterized by chronic physical and psychological problems.
Anyone can develop sepsis from an infection. This can happen rapidly and unpredictably, so it’s important to know the signs and symptoms. When signs and symptoms develop, it is a medical emergency. Seek immediate medical attention (call 911) for any combination of fever, chills, rapid heart rate, shortness of breath, confusion, or disorientation. Without prompt treatment in a hospital, sepsis can swiftly lead to organ failure and death.
What are the symptoms of sepsis?
There is no single symptom that points to sepsis. Instead, sepsis consists of a combination of symptoms that appear with an infection. Recognizing sepsis symptoms early is vital to prevent organ damage and loss of life.
It’s important to know that most people who develop sepsis are already in the hospital. However, you can develop the condition outside the hospital, such as at home after surgery, after discharge from the hospital, or if you have other risk factors. Remember, you may not even realize you have an infection when sepsis symptoms develop.
How to spot sepsis
Symptoms can include any of the following:
- Confusion or disorientation
- Fever or chills
- Pain or discomfort
- Rapid heart rate
- Shortness of breath or rapid breathing
- Sweaty or clammy skin
Sepsis is progressive. The signs and symptoms can quickly become severe. Signs that the condition is progressing to serious organ problems can include:
- Difficulty breathing
- Liver enzyme problems, which is a laboratory finding
- Low or no urine output
- Mental status changes
Sepsis can also progress to septic shock, which is the most dangerous form of sepsis. Septic shock occurs when your blood pressure drops rapidly and dangerously low. This can lead to heart failure, other organ failure, and death.
Sepsis, even early sepsis, is a medical emergency. Seek immediate medical attention (call 911) if you suspect sepsis. Sepsis can be fatal in a short amount of time. It is better to be mistaken and call 911 than to delay potentially life-saving medical care.
What causes sepsis?
Sepsis occurs when your body overreacts to an infection. It pumps immune-related substances into your blood. These substances normally help your body fight infections. However, the extreme reaction triggers inflammation throughout your body. This leads to a cascade of events. The blood becomes more prone to clotting and blood vessels become leaky. Blood can’t flow to organs and tissues the way it should. Without adequate blood flow, tissues can’t get oxygen and nutrients. This leads to damage, tissue death, and eventually organ failure and death.
An infection anywhere in the body can lead to sepsis. But there are four types of infections that most commonly lead to sepsis:
- Abdominal or gut infections
- Lung infections
- Skin infections
- Urinary tract or kidney infections
A variety of microorganisms can cause these infections, including bacteria, fungi and viruses. However, bacteria are the most common culprits.
What are the risk factors for sepsis?
Sepsis can affect anyone. However, certain people have an increased risk of developing sepsis. People who get sepsis at a higher rate compared to the general population include:
- Adults 65 year of age and older
- Children younger than one year
- People with chronic medical conditions, such as cancer, diabetes, or kidney, lung or liver disease
- People with a compromised or weak immune system, such as those with HIV or AIDS
- People with wounds including surgical wounds, injuries, or invasive devices such as catheters
Reducing your risk of sepsis
Sepsis can develop from any type of infection, even what appears to be a mild one. It is not always possible to prevent sepsis because you can’t prevent all infections, but you may be able to lower your risk of sepsis by:
- Caring for wounds and keeping cuts clean
- Keeping vaccinations up to date and getting adult vaccines as recommended by your doctor
- Practicing good hygiene including frequent and proper hand washing
- Treating chronic medical conditions
Ask your doctor about your personal risk of developing sepsis, especially when facing surgery or after hospitalization. Remember that sepsis is often hard to diagnose in the early stages because many things can cause the same symptoms. If you know you have risk factors, tell your doctor if you are concerned about sepsis. Make sure you are familiar with the warning signs if you are at risk or you care for someone at risk. Time is vital once the symptoms begin.
How is sepsis treated?
Sepsis is a medical emergency that requires treatment in a hospital. Sepsis treatment consists of intravenous (IV) antibiotics to halt the infection while supportive measures are administered to keep organs functioning, prevent further damage, and sustain blood pressure. Doctors maintain blood flow to organs and tissues with IV fluids. Supplemental oxygen is also important to make sure the blood flowing to the organs has enough oxygen. When sepsis becomes severe, other treatments may be necessary. This can include kidney dialysis, mechanical breathing machines, and surgery to remove the source of infection or damaged tissues.
Unfortunately, there is no treatment to directly target the extreme immune response that causes sepsis. Doctors use a variety of medicines to try to calm the immune system and support the organs. This can include corticosteroids, insulin for blood sugar control, pain medicines, and medicines to increase blood pressure.
What are the potential complications of sepsis?
It is possible to completely recover from sepsis, especially when it is mild. But blood clots and decreased blood flow can lead to permanent organ or tissue damage in some people. This can lead to amputation and the need for lifelong organ support, such as dialysis or breathing assistance. These problems are more likely to occur in people who already had chronic medical problems before developing sepsis.
People who have recovered from sepsis may also be at increased risk of future infections. Researchers believe sepsis disrupts a person’s normal immune function. This makes infections more likely.
Finally, people who survive sepsis can suffer from post-sepsis syndrome (PSS). Symptoms include:
- Fatigue, poor concentration, and decreased mental function
- Low self-esteem
- Muscle and joint pain
- Panic attacks
- Sleep problems, such as insomnia or nightmares
These chronic physical and psychological problems can affect up to 50% of survivors. PSS tends to strike older people and people who spent time in an intensive care unit. Researchers have linked sepsis to a similar disorder, PTSD (post-traumatic stress disorder). If you notice symptoms of PSS that persist, talk with your doctor. Mental health providers can assist you with counseling. Physical therapy and other forms of rehabilitation can also help you recover.