Sepsis

Overview of sepsis :   Sepsis occurs when your immune system has a dangerous reaction to an infection. It causes extensive inflammation throughout your body that can lead to tissue damage, organ failure and even death. Many different kinds of infections can trigger sepsis, which is a medical emergency. The quicker you receive treatment, the better your outcome will be.                                     Sepsis is a life-threatening medical emergency caused by your body’s overwhelming response to an infection. Without urgent treatment, it can lead to tissue damage, organ failure and death.

Sepsis definition

Sepsis is your body’s extreme reaction to an infection. When you have an infection, your immune system works to try to fight it. But sometimes your immune system stops fighting the infection and starts damaging your normal tissues and organs, leading to widespread inflammation throughout your body.

At the same time, an abnormal chain reaction in your clotting system can cause blood clots to form in your blood vessels. This reduces blood flow to the different organs of your body and can cause significant damage or even failure.

What are the three stages of sepsis?

Healthcare providers used to organize sepsis into three stages: sepsis, severe sepsis and septic shock. Now, they identify the condition on a more fluid scale. This scale ranges from infection and bacteremia (bacteria in your bloodstream) to sepsis and septic shock, which can lead to dysfunction of multiple organs and even death.

Who does sepsis affect?

Sepsis can affect anyone, but people with any kind of infection, especially bacteremia, are at a particularly high risk.

You're also at a high risk if you:

*Are over age 65.

*Are pregnant.

*Have certain medical conditions like diabetes, obesity, cancer and kidney disease.

*Have a weakened immune system.

Are in the hospital for other medical reasons.

*Have severe injuries like large burns or wounds.

*Have catheters, IVs or breathing tubes.        

Newborns and infants are another at-risk group.

How common is sepsis?

More than 1.7 million people in the United States receive a diagnosis of sepsis each year. There are differences in sepsis rates among different demographic groups. Sepsis is more common among older adults, with incidence increasing with each year after the age of 65 years old.

Symptoms and Causes

Nine symptoms of sepsis that require immediate medical attention.

Sepsis is a medical emergency. If you have any symptoms of sepsis, visit the emergency room.

What are the symptoms of sepsis?

Sepsis can affect many different areas of your body, so there are many possible symptoms.

If an infection such as blood poisoning (septicemia) triggered your condition, you may develop a sepsis rash on your skin. The rash makes your skin appear red and discolored. You may see small, dark-red spots on your skin.

Other common sepsis symptoms include:

*Urinary issues, such as reduced urination or an urge to urinate.

*Low energy/weakness.

*Fast heart rate.

*Low blood pressure.

*Fever or hypothermia (very low body temperature).

*Shaking or chills.

*Warm or clammy/sweaty skin.

*Confusion or agitation.

*Hyperventilation (rapid breathing) or shortness of breath.

*Extreme pain or discomfort.

What causes sepsis?

Bacterial infections are one of the most common causes of sepsis. Fungal, parasitic and viral infections are also potential sepsis causes. You can get sepsis when an infection triggers a chain reaction throughout your body causing organ dysfunction.

The infection leading to sepsis can start in many different parts of the body. Common sites and types of infections that can lead to sepsis include:

Respiratory system

Infections involving your lungs, such as pneumonia.

Urinary tract system

Urinary tract infections are especially likely if you have a catheter.

Gastrointestinal system

Infection of your appendix (appendicitis).

Bowel problems.

Infection in your abdominal cavity (peritonitis).

Gallbladder or liver infections.

Central nervous system

Infections of your brain or spinal cord.

Skin

Bacteria can enter your skin through wounds, inflammation or openings made with catheters and IVs.

Conditions such as cellulitis (inflammation of your skin’s connective tissue).

Is sepsis contagious?

Sepsis itself isn’t contagious — you can’t spread it to other people. But you can spread the infections that can cause sepsis.

Diagnosis and Tests

How is sepsis diagnosed?

It’s very important to quickly identify people with infections that may go on to develop sepsis. There are no strict criteria to diagnose sepsis. That’s why providers use a combination of findings — from a physical exam, lab tests, X-rays and other tests — to identify the infection (blood cultures) and diagnose sepsis.

Providers may sometimes suspect sepsis at bedside using the set of sepsis criteria — a tool called quick sequential organ failure assessment (qSOFA). You may have sepsis if you have confirmed or probable infection and at least two of the following criteria:                                                           Low blood pressure: Systolic blood pressure (the top number) reading of less than 100 mmHg (millimeters of mercury).

High respiratory rate: Respiratory rate faster than 22 breaths per minute.

Glasgow coma scale: A score of 15 or less on the Glasgow coma scale, which determines your level of consciousness.

Providers will request a number of additional tests to identify your infection and any organ damage or dysfunction. These tests may include:

Blood tests: Complete blood count (CBC), blood cultures, tests to check for abnormal liver and kidney function, clotting problems and electrolyte abnormalities.

Blood oxygen level: A test to evaluate the level of oxygen in your blood.

Urine tests: Urinalysis and urine culture.

Imaging tests: X-rays or CT scans.

Management and Treatment

How do you treat sepsis?

Sepsis treatment needs to begin immediately. The most important concern in sepsis protocol is a quick diagnosis and prompt treatment.

If your provider diagnoses you with sepsis, they’ll usually place you in the intensive care unit (ICU) of the hospital for special treatment. You may receive the following treatment for sepsis:

Antibiotics: You’ll receive antibiotics if you have a bacterial infection.

IV (intravenous) fluids: You’ll need fluids to maintain blood flow to your organs and prevent your blood pressure from dropping too low.

Vasopressor medications: Vasopressors tighten blood vessels. In some cases, you may need them to reach an adequate blood pressure.

Appropriate supportive care: If organ failures occur, you’ll need other sepsis treatments such as dialysis for kidney failure or mechanical ventilation for respiratory failure.

Surgery: You may need surgery to remove damaged tissue.