What is sepsis?

Sepsis is a potentially life-threatening illness in which the body has a severe response to an infection, whether viral, bacterial or fungal. Common types of infections that can lead to sepsis include pneumonia, abdominal, kidney or bloodstream infections (bacteremia). The immune system releases chemicals into the bloodstream to fight off the infection, triggering extensive inflammation responses throughout the body. This response can lead to blood clots and leaky vessels that may impair blood flow and cause organs to shut down. Once organs fail, blood pressure plummets, the heart grows weaker and the patient may die.

Sepsis can affect anyone, but it is most common among those with weakened immune systems, infants, children and the elderly. Severe sepsis affects approximately one million Americans each year, and between 28% and 50% of those affected die. It is the one of the leading causes of death in intensive care units.

Sepsis happens in three stages: first, sepsis, then severe sepsis and finally, septic shock. Sepsis may be difficult to diagnose in the early stage, because its symptoms closely mimic that of numerous other conditions. Symptoms of sepsis include:

Body temperature above 101°F or below 96.8°F;
Chills;
Confusion or delirium;
Probable or confirmed infection;
Rapid breathing, higher than 20 breaths per minute;
Rapid heartbeat, higher than 90 beats per minute;
Shaking;
Skin rash; and
Warm skin.

For a patient’s diagnosis to be upgraded to severe sepsis, they must exhibit one of the following, which may indicate organ failure:

Abdominal pain;
Decrease in platelet count;
Difficulty breathing;
Irregular heart pumping function;
Significantly decreased urine output; or
Sudden change in mental state.

Septic shock is diagnosed when a patient has the signs and symptoms of severe sepsis and has extremely low blood pressure that does not response to simple fluid replacement.

Doctors try to diagnose and treat sepsis while it is still in the mild stages. Broad-spectrum antibiotics are started immediately, and after blood tests pinpoint the microbe responsible, a more specific antibiotic targeting the microbe may be administered. A patient will also receive oxygen and IV fluids to maintain normal blood oxygen levels and blood pressure. If organ failure or other complications have occurred, a patient may also need blood pressure medication, dialysis or mechanical ventilation. Surgery may also be needed to clear an infection.

If a patient survives sepsis, damage caused to vital organs, such as the heart, brain and kidneys, due to lack of blood flow, may be permanent. There is also some evidence that severe sepsis can disturb a patient’s immune system, making them more susceptible to future infections.

Additional information about sepsis may be found at these websites:

http://www.mayoclinic.org/diseases-conditions/sepsis/basics/definition/con-20031900?p=1

http://www.nigms.nih.gov/Education/pages/factsheet_sepsis.aspx

http://www.nlm.nih.gov/medlineplus/ency/article/000666.htm