Sepsis (Blood Infection): Symptoms, Causes & Treatments

Written by Mary Anne Dunkin

• What Is Sepsis?
• Sepsis Causes and Risk Factors
• Sepsis Symptoms
• Sepsis Diagnosis
• Sepsis Treatment
• Sepsis Complications
• Sepsis Prevention
• More

Sepsis is when your body has an unusually severe response to an infection. It’s sometimes called septicemia.

During sepsis, your immune system, which defends you from germs, releases a lot of chemicals into your blood. This triggers widespread inflammation that can lead to organ damage. Clots reduce blood flow to your limbs and internal organs, so they don’t get the nutrients and oxygen they need.

In severe cases, sepsis causes a dangerous drop in blood pressure. Doctors call this “septic shock.” It can quickly lead to organ failure, such as your lungs, kidneys, and liver. This can be deadly.

Bacterial infections are most often to blame for sepsis. But it can also happen because of other infections. It can begin anywhere bacteria, parasites, fungi, or viruses enter your body, even something as small as a hangnail.

An infection of the bone, called osteomyelitis, could lead to sepsis. In people who are hospitalized, bacteria may enter through IV lines, surgical wounds, urinary catheters, and bed sores.

Sepsis is more common in people who:

• Have weakened immune systems because of conditions like HIV or cancer or because they take drugs such as steroids or those that prevent rejection of transplanted organs
• Are pregnant
• Are very young
• Are elderly, especially if they have other health problems
• Were recently hospitalized or had major surgeries
• Use catheters or breathing tubes
• Have diabetes
• Have a serious medical condition such as appendicitis, pneumonia, meningitis, cirrhosis, or a urinary tract infection

Because it can begin in different parts of your body, sepsis can have many different symptoms. The first signs may include rapid breathing and confusion. Other common symptoms include:

• Fever and chills
• Very low body temperature
• Peeing less than usual
• Fast heartbeat
• Nausea and vomiting
• Diarrhea
• Fatigue or weakness
• Blotchy or discolored skin
• Sweating or clammy skin
• Severe pain

Your doctor will do a physical exam and run tests to look for things like:

• Bacteria in your blood or other body fluids
• Signs of infection on an X-ray, CT scan, or ultrasound
• A high or low white blood cell count
• A low number of platelets in your blood
• Low blood pressure
• Too much acid in your blood (acidosis)
• A lack of oxygen in your blood
• Problems with how your blood clots
• Uneven levels of electrolytes
• Kidney or liver problems

Your doctor will probably keep you in the hospital’s intensive care unit (ICU). Your medical team will try to stop the infection, keep your organs working, and manage your blood pressure. IV fluids and extra oxygen can help with this.

Broad-spectrum antibiotics may fight infections caused by bacteria early on. Once your doctor knows what’s causing your sepsis, they can give you medicine that targets that specific germ. Often, doctors prescribe vasopressors (which make your blood vessels narrow) to improve blood pressure. You could also get corticosteroids to fight inflammation or insulin to keep control of your blood sugar.

If your case is severe, you might need other types of treatment, like a breathing machine or kidney dialysis. Or you may need surgery to drain or clean out an infection.

As sepsis gets worse, it causes more problems throughout your body. These may include:

• Kidney failure
• Dead tissue (gangrene) on fingers and toes, leading to amputation
• Lung, brain, or heart damage
• A higher risk of infections over time

Sepsis can be deadly in between 25% and 40% of cases.  

Preventing infection is the best way to prevent sepsis. Take these steps:

• Wash your hands often with soap and water for at least 20 seconds each time.
• Keep up with recommended vaccines for things like flu and chickenpox.
• Keep control of any chronic health conditions.
• If you have an injury that’s broken your skin, clean it as soon as possible. Keep it clean and covered as it heals, and watch for signs of infection.
• Treat any infections. Get medical care right away if they don’t get better or if they seem like they’re getting worse.

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Sepsis – Symptoms & causes

Overview

Sepsis is a serious condition in which the body responds improperly to an infection. The infection-fighting processes turn on the body, causing the organs to work poorly.

Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can damage the lungs, kidneys, liver and other organs. When the damage is severe, it can lead to death.

Early treatment of sepsis improves chances for survival.

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Symptoms

Symptoms of sepsis

Symptoms of sepsis may include:

• Change in mental status.
• Fast, shallow breathing.
• Sweating for no clear reason.
• Feeling lightheaded.
• Shivering.
• Symptoms specific to the type of infection, such as painful urination from a urinary tract infection or worsening cough from pneumonia.

Symptoms of sepsis are not specific. They can vary from person to person, and sepsis may appear differently in children than in adults.

Symptoms of septic shock

Sepsis may progress to septic shock. Septic shock is a severe drop in blood pressure. Progression to septic shock raises the risk of death. Symptoms of septic shock include:

• Not being able to stand up.
• Strong sleepiness or hard time staying awake.
• Major change in mental status, such as extreme confusion.

When to see a doctor

Any infection could lead to sepsis. Go to a health care provider if you have symptoms of sepsis or an infection or wound that isn’t getting better.

Symptoms such as confusion or fast breathing need emergency care.

Causes

Any type of infection can lead to sepsis. This includes bacterial, viral or fungal infections. Those that more commonly cause sepsis include infections of:

• Lungs, such as pneumonia.
• Kidney, bladder and other parts of the urinary system.
• Digestive system.
• Bloodstream.
• Catheter sites.
• Wounds or burns.

Risk factors

Some factors that increase the risk infection will lead to sepsis include:

• People over age 65.
• Infancy.
• People with lower immune response, such as those being treated for cancer or people with human immunodeficiency virus (HIV).
• People with chronic diseases, such as diabetes, kidney disease or chronic obstructive pulmonary disease (COPD).
• Admission to intensive care unit or longer hospital stays.
• Devices that go in the body, such as catheters in the vein, called intravenous, or breathing tubes.
• Treatment with antibiotics in the last 90 days.
• A condition that requires treatment with corticosteroids, which can lower immune response.

Complications

As sepsis worsens, vital organs, such as the brain, heart and kidneys, don’t get as much blood as they should. Sepsis may cause atypical blood clotting. The resulting small clots or burst blood vessels may damage or destroy tissues.

Most people recover from mild sepsis, but the mortality rate for septic shock is about 30% to 40%. Also, an episode of severe sepsis raises the risk for future infections.

Blood poisoning – symptoms, signs

Such a pathology as blood poisoning after the body is damaged by any pathogenic microbes is a systemic – affecting various organs – inflammatory process provoked by infection. Medical workers often use the term “Sepsis” to refer to this pathology – literally translated from Greek means “putrefactive process”.

Blood infection after infection of this biological fluid with unicellular fungi or various types of pathogenic bacteria – staphylococci and streptococci, enterococci and meningococci, Pseudomonas aeruginosa, etc., is extremely difficult. It is important to understand that spontaneous recovery in a patient with such a disease cannot occur, and in the absence of qualified medical care, even a fatal outcome is not ruled out.

Causes of blood poisoning

The development of blood poisoning after the body is damaged by pathogens is more provoked not so much by the pathogenic properties of the pathogenic microorganism as by the weakened state of the patient’s immunity. If a person’s immune system has been seriously affected due to the presence of someone with a chronic sluggish disease, as well as due to the fact that in the recent past he has lost a lot of blood or underwent abdominal surgery, then he is at risk of getting blood poisoning. The worse the patient’s immune system copes with its functions, the higher the likelihood that pathogenic bacteria will not be localized in only one organ, but will spread through the bloodstream throughout his body.

If we talk about specific reasons that provoke the development of sepsis in a patient, then these may include:

• penetration of infection from the outside due to violation of the integrity of the skin and other tissues of the body – for example, setting droppers, all kinds of surgical interventions, etc.;
• spread of infection throughout the body from purulent inflammations – boils, carbuncles, etc.;
• various infectious diseases of the urinary tract, etc.

It makes sense to mention separately how high the risk of signs of blood poisoning after an abortion or childbirth is: in this case, pathogens “introduce” into the woman’s body through the mucous membrane lining the uterus from the inside. It is for this reason that the death rate of women due to clandestine abortions was so high in those years when abortion was not yet a legal procedure.

Symptoms of blood poisoning

Regardless of the activity of which pathogenic microorganism provoked the development of sepsis, the symptoms of blood poisoning are always the same:

• weakness, loss of working capacity;
• loss of appetite up to its complete disappearance;
• chills, fever;
• headache;
• palpitations;
• lowering blood pressure;
• shortness of breath, etc.

Signs of blood poisoning are gradually increasing – the patient may gradually develop renal, cardiac, respiratory and other types of insufficiency. A blood test reveals an increased concentration of white blood cells in it and a sharply increased ESR.

Detection and treatment of blood poisoning

Diagnosis of this pathology, in addition to determining the patient’s signs of blood infection, provides for all kinds of measures to identify infectious agents in the blood, as well as to detect foci of infection in various tissues and organs. The sooner a correct diagnosis is made and qualified treatment of sepsis is started, the more likely it is that the recovery will be complete and not remote in time.

As for the treatment of blood poisoning, it certainly involves taking medications aimed at suppressing pathogenic bacteria or fungi, depending on which pathogens provoked the infection. It is also necessary therapy aimed at eliminating the symptoms of intoxication of the body. Sometimes it is impossible to do without a transfusion of donor blood. In the absence of treatment for blood poisoning, there is a real risk to the life and health of the patient.

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Sepsis – causes, symptoms, diagnosis and treatment of blood poisoning

This is a dangerous condition associated with the penetration of infectious agents into the blood. Against its background, poisoning of the body develops, and without proper therapy, a syndrome of multiple organ failure occurs. Sepsis can cause severe complications or even death of the patient. An important role in preventing such consequences is played by early diagnosis and a properly selected treatment program.

Causes of sepsis

Sepsis is an infectious disease. Most often it occurs when infected with streptococci and staphylococci. In some cases, the pathogens can be Escherichia and Pseudomonas aeruginosa, salmonella, pneumococci. The gates of the disease are wounds, as well as a long course of the inflammatory process. The risk of developing sepsis increases significantly if:

1. The patient has a weakened immune system. Pregnant women, the elderly, and newborns are at the highest risk of developing this condition. Also, sepsis can develop after a long illness, against the background of cancer therapy, with malnutrition.

2. The patient is taking drugs that suppress the functions of the immune system. Immunosuppressants are included in the treatment program for many pathologies. Regular use of medications increases the risk of a bacterial common infection.

3. There was a lot of blood loss. Bulk bleeding also weakens the body. The condition occurs against the background of damage to large veins or arteries. The elderly and infants are especially sensitive to blood loss.

4. There is a history of purulent disease. Purulent foci occur due to a violation of hygiene, against the background of cuts or wounds, due to friction of the skin with clothing. All this leads to the penetration of bacteria. Without adequate therapy, a boil, carbuncle or phlegmon can lead to sepsis.

5. There is a postoperative period. During surgery, bacteria can be introduced to the mucous membranes of the internal organs.

6. Inflammatory diseases present. The primary foci of infection can be inflamed appendicitis, pancreas, sinusitis, sinusitis and other pathologies associated with an intense inflammatory process.

7. History of extensive trauma. These include not only wounds, but also open fractures, burns.

8. Parasites detected. The vital activity of worms and fungi refers to the causes of the condition.

9. Performing invasive procedures. Catheters, cannulas and probes also lead to the penetration of infections into the body.

10. Long-term inpatient treatment. It is associated with infection with nosocomial infections, the formation of bedsores and general weakening.

This is not a complete list of causes of the condition. Sepsis threatens the entire body, so it is important to identify the cause and localization in a short time.

Pathogenesis

Infection of the blood involves a complex process that takes place in several stages. First, bacterial agents penetrate the blood and lymph from the primary focus. And in response, the immune system releases endogenous substances that lead to obstruction of the endothelium of the vascular wall. Under the influence of free radicals, the process of blood clotting is activated. The latter leads to DIC – a disorder of homeostasis, expressed in thrombotic, hemorrhagic and microcirculatory disorders.

In parallel, toxic compounds containing oxygen are released. These include hydrogen peroxide and nitric oxide. The amount of fluid passing through the circulatory and lymphatic systems decreases, and oxygen utilization by the organs becomes less. The result of the inflammatory reaction is hypoxia and multiple organ failure.

Classification

The classification of sepsis is based on the location of the infection gate. If they cannot be detected, then sepsis is recognized as primary. If localization is established, then the pathology is secondary. The latter implies the following types:

1. Obstetrics and gynecology. Often, infectious agents penetrate the uterine mucosa during childbirth or during an abortion. It is often associated with the fact that the doctor violated sanitary standards during the operation or during the delivery.

2. Surgical. Debuts from the wound left after surgery.

3. Dermal. It occurs as a result of skin diseases and damage to the dermis. Most often it develops from abscesses and wounds.

4. Urosepsis. The source of infection is located in the genitourinary system. Prerequisites may be prostatitis, pyelonephritis, cystitis.

5. Enteric. Localization of the gate of infection in the abdominal cavity.

6. Otogenic. It is mainly associated with purulent otitis or other infectious process of the ears.

7. Pleuropulmonary. In this case, the infection spreads from the lungs. Sepsis is a complication of pneumonia, empyema.

8. Odontogenic. Associated with diseases of the teeth and gums. Even banal caries can lead to sepsis.

9. Umbilical. It occurs exclusively in newborns suffering from omphalitis. Neonatal sepsis is associated with infectious diseases in the mother, childbirth outside the hospital, and a long anhydrous period.

10. Rhinogenic. Associated with an infectious process occurring in the sinuses and nasal cavity.

11. Tonsilogenic. The disease can debut due to a sore throat caused by streptococcus or staphylococcus aureus.

Symptoms of sepsis

The manifestation of the disease depends on the form of sepsis and the rate of development of the condition. The disease can progress in a short time, reaching severe stages in 1-2 days. There is a state of protracted flow, lasting 5-7 days. There are cases of chronic and subacute development. The condition may have a clear symptomatic picture or differ in a blurred atypical course. The standard symptoms of sepsis are fever, general weakness, the appearance of abscesses on the skin and organs. There may be shortness of breath, a violation of the pulse, a decrease in the amount of urine excreted. Consider the manifestations in accordance with the stages of pathology:

1. Sepsis. In this case, the bacteria are found in the blood, lymph, urine, cerebrospinal fluid. The patient has signs of peritonitis (abdominal pain, fever, nausea and vomiting) or other inflammatory diseases. For example, pneumonia, purpura, prostatitis in acute forms. At this stage, diagnosing blood poisoning is extremely difficult.

2. Severe sepsis. The patient is transferred to the intensive care unit. It combines the signs of the underlying disease and a number of aggravating symptoms. Significant disturbances in the work of internal organs are found. The patient’s pulse and respiration change. The digestive and urinary systems are unstable. Arterial hypotension develops – a pronounced decrease in pressure. Ischemia is diagnosed – a decrease in local blood circulation against the background of the same low pressure.

3. Septic shock. A condition with a high risk of death. Against the background of a decrease in blood supply to vital organs, every second patient dies. All of the symptoms listed above are exacerbated. Slowing down of urine synthesis, confusion of consciousness, stupor are diagnosed. The patient may go into a coma.

In some cases, the patient may develop septic psychosis. This condition is associated with the appearance of hallucinations, delusions, depression of mood. This is due to toxic damage to the brain.

Diagnosis

In the process of diagnosis, it is important not only to establish the fact of pathology, but also to identify the cause of sepsis. Knowing the pathogen, you can choose an effective treatment and normalize the condition in a short time. Diagnosis of sepsis takes place in several stages:

1. Patient examination. During the examination, the doctor examines breathing, the condition of the skin, measures pressure and heart rate. Be sure to measure the temperature and the amount of oxygen in the blood. If the patient is conscious, then the doctor collects an anamnesis.

2. Laboratory studies. A general blood test allows you to evaluate the number of platelets, as well as obtain data on the leukocyte formula. It is imperative to conduct a biochemical analysis in order to assess the level of C-reactive protein, a marker of the inflammatory process. Additionally, the level of creatinine, bilirubin is analyzed. Presepsin and procalcitonin are also specific markers.

3. Bacteriological culture. It is aimed at determining the pathogen, it is necessary for the selection of an antibiotic, it is carried out to monitor the effectiveness of the therapy. Detection of microbes in the blood is an important but not essential sign of sepsis. Unfortunately, even the most modern method of research is not always possible to isolate the pathogen from the blood. In 50% of cases, the analysis remains uninformative. A negative culture result in the presence of clinical symptoms should not be interpreted as the absence of sepsis.

4. PCR. This is a research method that allows you to isolate the DNA of the pathogen. It can be used alone or in parallel with bacterial seeding.

Treatment of sepsis

Treatment of sepsis is based on the correct selection of antibiotic therapy. It is based on determining the form of the pathogen, the stage and severity of the disease. The drugs are administered in large doses, taking into account the sensitivity of the bacteria and the patient’s response. Also in therapeutic tactics can be included:

1. Sulfonamides. Suppress the causative agent of infection, temporarily reducing the ability to reproduce. There are means of short and long action (with a cumulative effect).

2. Enhanced nutrition. To increase the body’s resistance, the patient must be introduced protein nutrition. Recommended fortified medical mixtures.

3. Specific sera, autovaccines, gamma globulin. They are a source of immunoglobulins that allow to destroy bacteria.

4. Surgical treatment. It is aimed at excision of the affected tissues and drainage of the gates of infection.

5. Osmotic ointments. They have pronounced antiseptic and sorption properties.

6. Blood transfusion. Indicated in violation of hemostasis.

7. Oxygen transport. To alleviate the condition, respiratory support and infusion of solutions are carried out to normalize the electrolyte balance.

Forecast. Prevention

The disease is associated with a high risk of complications:

• disorders of respiratory function and gas exchange;

• deterioration in the filtration capacity of the urinary system;

• increased blood clotting and DIC;

• polyneuropathies and difficulties with spontaneous breathing;

• septic shock and psychosis.