What is sepsis?
Sepsis is a medical emergency caused by the body's response to an infection and can be life-threatening. Sepsis is the consequence of widespread inflammation (swelling) in the body. Inflammation and blood clotting during sepsis causes reduced blood flow to limbs and vital organs, and can lead to organ failure and even death. Over 1.5 million people in the United States are diagnosed with sepsis yearly, and approximately 30% of patients do not survive.
Who is at risk for sepsis?
Sepsis can affect anyone, but those at particular risk include:
- The very old (older than 65 years old) or very young or pregnant women
- People with pre-existing infections or medical conditions such as diabetes, lung disease, cancer and kidney disease
- People with weakened immune systems
- Patients who are in the hospital
- People with severe injuries, such as large burns or wounds
- Patients with catheters (IVs, urinary catheters) or a breathing tube
Symptoms and Causes
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 infection of the appendix (appendicitis), bowel problems, infection of the abdominal cavity (peritonitis), and gallbladder or liver infections.
- The central nervous system: Infections of the brain or the spinal cord.
- The lungs: Infections such as pneumonia.
- The skin: Bacteria can enter skin through wounds or skin inflammation, or through the openings made with intravenous (IV) catheters (tubes inserted into the body to give or drain fluids). Conditions such as cellulitis (inflammation of the skin's connective tissue) can also cause sepsis.
- The urinary tract (kidneys or bladder): Urinary tract infections are especially likely if the patient has a urinary catheter to drain urine.
What are the symptoms of sepsis?
Because of the many sites on the body from which sepsis can originate, there are a number of symptoms. The most prominent are:
- Fast heart rate
- Fever or hypothermia (very low body temperature)
- Shaking or chills
- Warm or clammy/sweaty skin
- Confusion or disorientation
- Hyperventilation (rapid breathing) or shortness of breath
Diagnosis and Tests
How is sepsis diagnosed?
A person may have sepsis if he or she has:
Management and Treatment
How is sepsis treated?
The most important concern 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, obtain blood and urine tests and X-rays or CT scans, and give the patient antibiotics to treat the infection. (Note: Antibiotics are ineffective against infections caused by viruses.)
IV (intravenous or in the vein) fluids are administered to prevent blood pressure from dropping too low. In some cases, the patient may need vasopressor medications (which tighten blood vessels) to reach an adequate blood pressure. And finally, if organ failures occur, the patient will receive the appropriate supportive care (for example, dialysis for kidney failure, mechanical ventilation for respiratory failure, etc.).
How can I help prevent sepsis?
- Apply good hand-washing practices
- Keep up to date on recommended vaccines
- Get routine medical care for chronic conditions
- Get medical attention immediately if you suspect an infection