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Diseases & Conditions

Sepsis

(Also Called 'Systemic Inflammatory Response Syndrome')

Sepsis, also known as systemic inflammatory response syndrome (SIRS), is a serious medical condition caused by the body’s response to an infection. Sepsis can lead to widespread inflammation and blood clotting. Inflammation may result in redness, heat, swelling, pain, and organ dysfunction or failure. Blood clotting during sepsis causes reduced blood flow to limbs and vital organs, and can lead to organ failure or gangrene (damage to tissues).

What causes sepsis?

Bacterial infections are the most common cause of sepsis. Sepsis can also be caused by fungal, parasitic, or viral infections. The source of the infection can be any of a number of places throughout the body. Common sites and types of infection that can lead to sepsis include:

  • The abdomen—An inflammation of the appendix (appendicitis), bowel problems, infection of the abdominal cavity (peritonitis), and gallbladder or liver infections
  • The central nervous system—Inflammation or infections of the brain or the spinal cord
  • The lungs—Infections such as pneumonia
  • The skin—Bacteria can enter skin through wounds or skin inflammations, or through the openings made with intravenous (IV) catheters (tubes inserted into the body to administer or drain fluids). Conditions such as cellulitis (inflammation of the skin’s connective tissue) can cause sepsis.
  • The urinary tract (kidneys or bladder)—Urinary tract infections are especially likely if the patient has a urinary catheter to drain urine

Who is at risk for sepsis?

Sepsis can strike anyone, but those at particular risk include:

  • People with weakened immune systems
  • Patients who are in the hospital
  • People with pre-existing infections or medical conditions
  • People with severe injuries, such as large burns or bullet wounds
  • People with a genetic tendency for sepsis
  • The very old or very young

What are the symptoms of sepsis?

Because of the many sites on the body from which sepsis can originate, there is a wide variety of symptoms. The most prominent are:

  • Decreased urine output
  • Fast heart rate
  • Fever
  • Hypothermia (very low body temperature)
  • Shaking
  • Chills
  • Warm skin or a skin rash
  • Confusion or delirium
  • Hyperventilation (rapid breathing)

How is sepsis diagnosed?

A person may have sepsis if he or she has:

  • A high or low white blood cell count
  • A low platelet count
  • Acidosis (too much acid in the blood)
  • A blood culture that is positive for bacteria
  • Abnormal kidney or liver function

How is sepsis treated?

The most important intervention in sepsis is quick diagnosis and prompt treatment. Patients diagnosed with severe sepsis are usually placed in the intensive care unit (ICU) of the hospital for special treatment. The doctor will first try to identify the source and the type of infection, and then administer antibiotics to treat the infection. (Note: antibiotics are ineffective against infections caused by viruses.)

The doctor also administers IV fluids to prevent blood pressure from dropping too low. In some cases, vasopressor medications (which constrict blood vessels) are needed to achieve an adequate blood pressure. Some patients are given new drug therapies, such as activated protein C (APC). And finally, if organ failures occur, appropriate supportive care is provided (for example, dialysis for kidney failure, mechanical ventilation for respiratory failure, etc.).

References

Sepsis Alliance. Sepsis Defined. www.sepsisalliance.org Accessed 6/24/2011

King JE - Sepsis in Critical Care. Crit Care Nurs Clin North Am - 01-MAR-2007; 19(1): 77-86 Accessed 6/24/2011 via Mosby’s Nursing Consult

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/22/2011…#12361