What are the key symptoms of sepsis. How is sepsis diagnosed and treated. What complications can arise from sepsis. How can sepsis be prevented. What is the prognosis for sepsis patients. Who is at highest risk for developing sepsis. How does sepsis affect different organ systems.

Understanding Sepsis: A Potentially Life-Threatening Condition

Sepsis is a severe and potentially life-threatening condition that occurs when the body’s response to infection causes widespread inflammation and organ dysfunction. Recognizing the symptoms early and seeking prompt medical attention is crucial for improving outcomes. This article delves into the various aspects of sepsis, from its symptoms and diagnosis to treatment options and prevention strategies.

Identifying the Warning Signs: The TIME Acronym

Healthcare professionals use the TIME acronym to help identify potential sepsis cases. This easy-to-remember tool focuses on four key areas:

• T – Temperature changes (higher or lower than normal)
• I – Signs of Infection
• M – Mental decline
• E – Feeling Extremely ill

What specific temperature changes should raise concern? A fever above 100°F (37.7°C) or hypothermia (low body temperature) can both be indicators of sepsis. It’s important to note that while fever is more common, some individuals may experience a drop in body temperature instead.

Signs of Infection

How can you recognize signs of infection? Infections can manifest in various ways depending on the affected area. For instance:

• Urinary tract infections may cause frequent urination or burning sensations
• Pneumonia often presents with coughing and chest pain
• Skin infections typically show redness, swelling, or pus

In some cases, however, infections may not produce obvious symptoms. This is particularly true for individuals who have recently undergone surgery or invasive medical procedures.

Mental Status Changes

Why is mental decline a significant indicator of sepsis? Sepsis can affect brain function, leading to confusion, sleepiness, or difficulty in arousing the patient. These changes are often more pronounced in elderly individuals, who may experience a sudden worsening of existing dementia or confusion.

Feeling Extremely Ill

What does “feeling extremely ill” entail in the context of sepsis? Many sepsis survivors report experiencing the worst pain or discomfort of their lives during the onset of sepsis. This may include severe sore throat, intense abdominal pain, or a general feeling of impending doom.

Clinical Indicators: Beyond the TIME Acronym

While the TIME acronym provides a useful framework for initial assessment, healthcare professionals look for additional clinical indicators to diagnose sepsis. These include:

Inflammatory Markers

• Elevated white blood cell count
• Presence of immature white blood cells in circulation
• Increased levels of C-reactive protein and procalcitonin

Hemodynamic Changes

• Low blood pressure
• Reduced oxygen saturation in central or mixed venous blood
• Elevated cardiac index

Organ Dysfunction

• Decreased oxygen levels
• Reduced urine output
• Elevated blood creatinine
• Abnormalities in blood clotting
• Absence of bowel sounds
• Low platelet count
• High bilirubin levels

Tissue Perfusion Issues

• Elevated blood lactate levels
• Decreased capillary filling or skin mottling

Sepsis Treatment: A Time-Sensitive Approach

How is sepsis treated, and why is timely intervention crucial? The treatment of sepsis varies depending on the affected area, the cause of infection, the organs involved, and the extent of damage. However, prompt medical attention is essential in all cases.

Emergency Treatment and Intensive Care

When is intensive care necessary for sepsis patients? Individuals with severe sepsis or those who develop septic shock (dangerously low blood pressure) require emergency treatment or admission to an intensive care unit (ICU). These specialized units can support vital bodily functions, such as breathing, allowing medical staff to focus on treating the underlying infection.

Antibiotic Therapy

What role do antibiotics play in sepsis treatment? Antibiotics are the primary treatment for sepsis, severe sepsis, and septic shock. They are typically administered intravenously to ensure rapid absorption and distribution throughout the body.

How quickly should antibiotic treatment begin? Ideally, antibiotic therapy should commence within an hour of diagnosis to maximize its effectiveness.

Types of Antibiotics Used

Which antibiotics are used to treat sepsis? Initially, broad-spectrum antibiotics are administered to combat a wide range of potential infectious bacteria. Once the specific pathogen is identified through laboratory tests, a more targeted antibiotic may be prescribed.

How long does antibiotic treatment typically last? Intravenous antibiotics are usually replaced by oral medications after 2 to 4 days. The entire course of treatment may last 7 to 10 days or longer, depending on the severity of the condition.

Treating Viral Sepsis

Can antibiotics treat sepsis caused by viruses? Antibiotics are ineffective against viral infections. However, due to the time-sensitive nature of sepsis treatment, antibiotics are often administered before the causative agent is identified. In cases of confirmed viral sepsis, antiviral medications may be prescribed, and supportive care is provided to allow the immune system to combat the infection.

Fluid Resuscitation

Why is fluid administration important in sepsis treatment? Intravenous fluids play a crucial role in managing sepsis by helping to maintain blood pressure and ensure adequate perfusion of vital organs. The type and amount of fluids administered are carefully monitored and adjusted based on the patient’s individual needs and response to treatment.

Complications of Sepsis: Understanding the Risks

What potential complications can arise from sepsis? Sepsis can lead to various complications affecting multiple organ systems:

• Acute respiratory distress syndrome (ARDS)
• Kidney failure
• Liver dysfunction
• Heart failure
• Disseminated intravascular coagulation (DIC)
• Cognitive impairment
• Post-sepsis syndrome

How does sepsis affect long-term health? Some sepsis survivors experience ongoing physical and psychological effects, collectively known as post-sepsis syndrome. These may include fatigue, muscle weakness, cognitive difficulties, anxiety, and depression.

Preventing Sepsis: Strategies for Reducing Risk

How can individuals reduce their risk of developing sepsis? While it’s not always possible to prevent sepsis, several strategies can help minimize the risk:

• Practicing good hygiene, including regular handwashing
• Keeping wounds clean and protected
• Staying up-to-date with vaccinations
• Managing chronic health conditions effectively
• Seeking prompt medical attention for infections

Who is at higher risk for developing sepsis? Certain groups are more susceptible to sepsis, including:

• Elderly individuals
• Infants and young children
• People with weakened immune systems
• Individuals with chronic medical conditions
• Those recovering from major surgeries or severe injuries

Sepsis Awareness: The Importance of Education

Why is public awareness about sepsis crucial? Increasing public knowledge about sepsis can lead to earlier recognition of symptoms and prompt medical intervention, potentially saving lives. Healthcare providers, patients, and caregivers should be educated about the warning signs and the importance of timely treatment.

Global Impact of Sepsis

What is the global burden of sepsis? Sepsis affects millions of people worldwide each year and is a leading cause of death in hospitals. It places a significant strain on healthcare systems and resources.

Sepsis Research and Future Directions

How is ongoing research contributing to sepsis management? Scientists and medical professionals continue to investigate new diagnostic tools, treatment strategies, and preventive measures for sepsis. Areas of focus include:

• Biomarker discovery for earlier and more accurate diagnosis
• Novel therapeutic approaches, including immunomodulatory treatments
• Personalized medicine strategies for optimizing sepsis care
• Development of rapid diagnostic tests for identifying causative pathogens

Living with the Aftermath: Support for Sepsis Survivors

What resources are available for sepsis survivors and their families? Various organizations provide support, information, and resources for those affected by sepsis:

• Sepsis Alliance
• Global Sepsis Alliance
• Local support groups and online communities
• Rehabilitation services for physical and cognitive recovery
• Mental health support for managing post-sepsis psychological effects

How can healthcare systems improve long-term care for sepsis survivors? Implementing comprehensive follow-up care programs, including physical therapy, occupational therapy, and psychological support, can help address the diverse needs of sepsis survivors and improve their quality of life.

In conclusion, sepsis remains a significant global health challenge, but increased awareness, prompt recognition of symptoms, and timely intervention can significantly improve outcomes. By understanding the warning signs, risk factors, and available treatments, individuals and healthcare providers can work together to combat this life-threatening condition and support those affected by its aftermath.

Symptoms | Sepsis Alliance

Click here to download this symptoms card.

It’s important to look for a combination of the warning signs of sepsis. Spotting these symptoms early could prevent the body from entering septic shock, and could save a life.

T – Temperature higher or lower.

Your body’s temperature should stay fairly constant, around 98.6 degrees Fahrenheit (37 degrees Celsius), moving up or down a bit depending on your activity, the environment, and time of day. A temperature of 100 degrees Fahrenheit (37.7 degrees Celsius) is considered to be hyperthermia, a fever. When you have an infection, your body’s temperature usually rises as it tries to fight off the bug causing the infection. Interestingly, some people see their body temperature go down (hypothermia) instead of up. This is why any change, high or low, can be a sign of sepsis.

I – Infection – may have signs and symptoms of an infection.

If you have a local infection, like a urinary tract infection, pneumonia, or an infected cut, the signs and symptoms are localized according to the area affected (needing to urinate or burning on urination for a UTI, coughing and chest pain for pneumonia, redness and pus for an infected cut, for example). If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc.

Sometimes however, you may have an infection and not know it, and not have any symptoms. Keep this in mind especially if you have recently had surgery or an invasive medical procedure, a break in your skin, or you have been exposed to someone who is ill.

M – Mental decline – confused, sleepy, difficult to rouse.

Sepsis can affect your mental status. Some people, especially the elderly, may not show typical signs of infection. Instead, they may show a sudden change in mental status, becoming confused, or a worsening of dementia and confusion. Sleepiness, often severe, is also a common complaint.

E – Extremely ill –  severe pain or discomfort, shortness of breath.

Many sepsis survivors have said that when they were ill, it was the worst they ever felt. It was the worst sore throat, worst abdominal pain, or they felt that they were going to die.

Children developing sepsis may exhibit different symptoms, as seen below.

Healthcare professionals look for the following signs and symptoms, as well as those listed above, to determine a diagnosis. They include:

Inflammatory

• High white blood cell count
• Immature white blood cells in the circulation
• Elevated plasma C-reactive protein
• Elevated procalcitonin (PCT)

Hemodynamic

• Low blood pressure
• Low central venous or mixed venous oxygen saturation
• High cardiac index

Organ Dysfunction

• Low oxygen level
• Low urine output
• High creatinine in the blood
• Coagulation (clotting) abnormalities
• Absent bowel sounds
• Low platelets in the blood
• High bilirubin levels

Tissue Perfusion

• High lactate in the blood
• Decreased capillary filling or mottling

Sepsis | NHS inform

Treatment for sepsis varies, depending on the:

• area affected
• cause of the infection
• organs affected
• extent of any damage

If you have the early signs of sepsis, you’ll usually be referred to hospital. You’ll then be given a diagnosis and treatment.

Emergency treatment

You’ll need emergency treatment, or treatment in an intensive care unit (ICU), if:

• the sepsis is severe
• you develop septic shock – when your blood pressure drops to a dangerously low level

ICUs can support body functions like breathing that are affected by sepsis. This allows the medical staff to focus on treating the infection.

Sepsis is treatable if it’s identified and treated quickly. In most cases it leads to full recovery with no lasting problems.

Antibiotics

The main treatment for sepsis, severe sepsis or septic shock is antibiotics. These will be given directly into a vein (intravenously).

Ideally, antibiotic treatment should start within an hour of diagnosis.

Intravenous antibiotics are usually replaced by tablets after 2 to 4 days. You may have to take them for 7 to 10 days or longer, depending on the severity of your condition.

Types of antibiotics

If sepsis is suspected, broad-spectrum antibiotics are given first. This is because there won’t be time to wait until a specific type of infection has been identified.

Broad-spectrum antibiotics work against a wide range of known infectious bacteria. They usually cure most common infections.

Once a specific bacterium has been identified, a more focused antibiotic can be used.

Viral infections

If the sepsis is caused by a virus, antibiotics won’t work. However, it would be too dangerous to delay treatment to find out the specific cause. This means antibiotics are usually given anyway.

With a viral infection, you’ll need to wait until your immune system starts to tackle it. However, antiviral medication may be given in some cases.

Intravenous fluids

If you have sepsis, your body needs more fluid to prevent dehydration and kidney failure.

If you have severe sepsis or septic shock, you’ll usually be given fluids intravenously for the first 24 to 48 hours.

It’s important that the doctors know how much urine your kidneys are making when you have sepsis. This helps them spot signs of kidney failure.

If you’re admitted with severe sepsis or septic shock, you’ll usually be given a catheter. This is inserted into your bladder to monitor your urine output.

Oxygen

Your body’s oxygen demand goes up if you have sepsis.

If you’re admitted to hospital with sepsis and the level of oxygen in your blood is low, you’ll usually be given oxygen. This is given through a mask or tubes in your nostrils.

Treating the source of infection

If a source of the infection can be identified, like an abscess or infected wound, this will also need to be treated.

For example, any pus may need to be drained away. In more serious cases, surgery may be needed to remove the infected tissue and repair any damage.

Increasing blood pressure

Medications called vasopressors are used if you have low blood pressure caused by sepsis.

Vasopressors are normally given intravenously while you’re in an ICU. Extra fluids may also be given intravenously to help increase blood pressure.

Other treatments

You may require additional treatments like:

• corticosteroids
• insulin medication
• a blood transfusion
• mechanical ventilation – where a machine is used to help you breathe
• dialysis – where a machine filters your blood to copy the function of your kidneys

These treatments are mostly used in ICUs.

Viral gastroenteritis – Humanitas

Viral gastroenteritis – is an infection of the intestines that is characterized by watery stools, abdominal cramps, nausea or vomiting, and sometimes fever.

The most common viral gastroenteritis (sometimes called “stomach flu”) is transmitted through contact with a sick person or ingestion of contaminated food or water. If the state of health is otherwise normal, recovery will probably not be accompanied by complications. However, in infants, the elderly, and people with suppressed immune systems, viral gastroenteritis can be fatal.

There is no effective treatment for viral gastroenteritis, so prevention is becoming more important. In addition to avoiding food and water that may be contaminated, the best defense is thorough and frequent handwashing.

Symptoms

Despite the common name “stomach flu”, gastroenteritis is different from the flu. The true flu only affects the respiratory system: nose, throat and lungs. Gastroenteritis affects the intestines, causing the following signs and symptoms:

• Watery stools, usually without blood – bloody diarrhea often indicates another, more severe infection.
• Abdominal cramps and pain
• Nausea, vomiting or both
• Periodic muscle pain and headaches
• Low temperature

Depending on the cause, symptoms of viral gastroenteritis may appear within one to three days after infection and may be mild or severe. Symptoms usually persist for one to two days, but can sometimes persist for up to 10 days.

Because the symptoms are similar, viral diarrhea can easily be mistaken for diarrhea caused by bacteria, such as salmonella and E. coli, or parasites, such as giardia.

Conditions requiring medical attention

An adult should seek medical attention in the following cases:

• Fluid is not retained within 24 hours
• Vomiting for more than two days
• Hematemesis
• Dehydration: Signs of dehydration include extreme thirst, dry mouth, deep yellow urine, infrequent or no urination, severe weakness, dizziness, or lightheadedness.
• Detection of blood impurities in feces
• Temperature above 40°C (104°F)
• In infants and young children

If your child has any of the following symptoms, see a doctor immediately:

• Temperature 38.9C (102 F) and above
• Drowsiness or irritability
• Feeling that the child is in severe discomfort or pain
• Bloody diarrhea
• Child feels dehydrated: monitor for signs of dehydration in sick infants and young children by comparing fluid intake and urine output with the child’s normal intake

If you have a small child, remember that if daily spitting up is not a cause for concern, then vomiting is not the norm. Vomiting in children appears for various reasons, many of which require medical intervention.

If a child has any of the following, see a doctor immediately:

• Vomiting for several hours
• Diaper dry for six hours
• Bloody stools or severe diarrhea
• Sunken fontanel – soft spot on top of child
• The child has a dry mouth or no tears when crying
• Unusual drowsiness, no response

Complications

The main complication of viral gastroenteritis is severe loss of water and important salts and minerals. If the body is healthy and the person is drinking enough fluid to replace the fluid excreted through vomiting or diarrhea, dehydration is not dangerous.

Young children, the elderly, or people with a suppressed immune system can become severely dehydrated if the amount of fluid they take in cannot replace the amount of fluid lost. In this case, hospitalization may be required, where the lost fluid will be restored intravenously. In rare cases, dehydration can lead to death.

description of the disease, causes, symptoms, diagnosis and treatment

Hypothermia is a violation of heat transfer, which is manifested by a significant decrease in body temperature (less than 35.5°C). Occurs with prolonged exposure to low ambient temperatures or a decrease in heat production and an increase in its return. Hypothermia often becomes a sign of certain diseases.

Mechanism of heat production

Mandatory heat production is the heat that is produced during the body’s metabolic processes. It is enough to maintain normal body temperature, but only if the ambient temperature is comfortable. For an adult, the range from 18 to 23 ° C is considered comfortable, but with minimal physical activity and light clothing. When the body is hypothermic, muscle tone increases, so muscle tremors appear.

However, there is the concept of additional heat production. It becomes active if the air temperature becomes too low. Additional heat production includes contractile thermogenesis, which is based on involuntary muscle contraction, as well as non-contractile thermogenesis, carried out by splitting brown fat. It is practically absent in adults, since it regresses with growing up. Brown adipose tissue is located in the area of ​​​​the kidneys, shoulder blades, on the neck. Young children have more of it, and it is metabolically very active, because it protects them from severe hypothermia.

The metabolic rate is influenced by thyroid and adrenal hormones. The thermoregulatory center is located in the hypothalamus. The central body temperature is measured in the oral cavity, rectum, ear canal, and in a medical institution – in the bladder, nasopharynx and esophagus. In the central vessels and most internal organs, it is maintained at a level of 36–38°C.

Peripheral body temperature is measured in the armpits or on the forehead. Normally, it is slightly below the center.

Temperature readings are individual for each person and differ depending on the part of the body. There is a certain norm, which changes slightly during the day.

Causes of hypothermia

Possible causes of decreased body temperature include:

• CNS pathology;
• low muscle mass;
• alcohol or other intoxication;
• prolonged physical activity;
• decreased metabolic rate;
• period of pregnancy;
• drug exposure;
• recovery period after a long illness.

Hypothermia is also caused by prolonged exposure to ice-cold water, wet clothing, and low ambient temperatures. These factors often lead to disruption of thermal exchange and heat loss.

Types of low temperature

Hypothermia is endogenous, when pathologies of internal organs are observed, or exogenous, when body temperature depends on external factors.

Medical hypothermia is also classified as exogenous. It is used when a temporary slowdown in blood circulation is required. That is, its task is to reduce metabolism and activity in organs and tissues. This is necessary to increase resistance to lack of oxygen. Medical hypothermia is indicated during open surgical interventions on the heart and blood vessels, with injuries of the brain and spinal cord, ischemic stroke, neonatal hypoxia.

The following types of low temperature are noted:

1. Mild degree – observed at body temperature from 32.2 to 35 ° C, characterized by drowsiness, chills, increased heart rate and respiration.
2. Medium degree – noted at a temperature of 27 to 32.1 ° C, it is characterized by a decrease in reflexes, bradycardia and slow breathing.
3. Severe degree – observed at temperatures below 27 ° C, when a person is in a depressed state, and he completely lacks reflexes.

The degree of severity is assessed by the doctor not only by the level of decrease in the central temperature, but also by some clinical signs.

Pathologies causing hypothermia

The most rare causes include:

• spinal cord injury;
• terminal liver failure;
• septic condition;
• uremia;
• certain types of diabetes.

Common causes of hypothermia include heart attack and stroke, Addison’s disease, hypothyroidism, anemia, hypoglycemia, as well as VSD and depression.

Body temperature may decrease during shock conditions, with a sharp expansion of blood vessels. Heat transfer increases many times, and the body temperature drops by 4-5 ° C below the accepted norm. If this is combined with chest pain and low blood pressure, then myocardial infarction is possible.

Occasionally, hypothermia is caused by ischemic stroke. The patient feels drowsiness, some stupor, a short-term loss of consciousness is possible. As a rule, neurological symptoms and temperature decrease increase gradually.

A decrease in temperature below 32°C is noted with hemorrhages or inflammatory processes in the hypothalamus. When the posterior hypothalamus is affected, temperature fluctuations associated with the environment (poikilothermia) are observed. In cold conditions, a hypothermic coma is possible with irreversible consequences for some parts of the brain.

Addison’s disease is also often the cause of a decrease in temperature. Corticosteroids, which are synthesized by the adrenal glands, maintain the metabolism at the proper level, including the temperature. However, with their insufficient production, a number of disorders appear, against their background, the body temperature drops. A sudden decrease in blood pressure, muscle weakness, loss of consciousness, combined with a temperature below 33 ° C, indicate an Addisonian crisis.

Hypothyroidism slows down metabolism, and the brain center responsible for proper thermoregulation reduces its activity. Such conditions negatively affect the skin: pallor, waxiness are the main signs. Due to microcirculation disorders, hair can fall out. The patient complains of loss of strength, constant drowsiness.

Initially, with hypoglycemia, there is a slight decrease in temperature, but if the causes are not eliminated, the condition rapidly worsens, and the temperature continues to decrease. Deep syncope is possible, because with hypoglycemia, energy starvation of the brain occurs.

Hypothermia in anemia is caused by low levels of red blood cells and hemoglobin. Among the clinical signs are headache, darkening in the eyes, fatigue. The condition of nails, hair, skin worsens.

In VVD, hypothermia is caused by impaired blood circulation and autonomic regulation. Such conditions are characterized by weakness, dizziness, trembling in the limbs. Such attacks occur periodically, they are provoked by prolonged stress, physical activity, prolonged stay in a stuffy room.

It is not uncommon to have a low body temperature after a viral infection. This is due to the sluggish activity of the immune system and the depletion of the body. Among the symptoms of asthenia are fatigue, weakness, drowsiness. The condition persists for 2-3 weeks.

In some cases, hypothermia is noted in depression, as associations change and the limbic system is disturbed, which causes malfunctions in the thermoregulatory center. However, temperatures are rarely set below 34.5°C, although hypothermia in depressive disorders is prolonged. Along with a low temperature, patients experience depression, sleep problems, they have cold extremities with a marbled pattern on the skin.

Hypothermia is possible with various intoxications of the body. Toxins, accumulating in the blood, penetrate into the parts of the brain, disrupting the transmission of impulses. Under the influence of toxic compounds, the body temperature decreases, the general condition of the body worsens.

Which doctor should I contact if my body temperature drops?

If a slight decrease in temperature, which is not associated with hypothermia, persists for a long time, then it is necessary to consult a general practitioner, neurologist, endocrinologist.

In case of a sharp drop in temperature, which is accompanied by other life-threatening symptoms, severe hypothermia, an ambulance will be required.

Diagnosis of hypothermia

The volume of diagnostic measures depends on the degree of temperature decrease and the general condition of the body.