What are the key symptoms of sepsis. How is sepsis diagnosed and treated. What role do antibiotics play in managing sepsis. When is emergency treatment necessary for sepsis. How can early detection of sepsis save lives.

Recognizing the Warning Signs: The TIME Approach to Sepsis Symptoms

Sepsis is a life-threatening condition that requires immediate medical attention. To help identify sepsis early, healthcare professionals use the TIME approach, which stands for Temperature, Infection, Mental decline, and Extremely ill. Let’s explore each of these components in detail:

Temperature Changes in Sepsis

How does sepsis affect body temperature. Sepsis can cause significant fluctuations in body temperature. While a fever (hyperthermia) is common, some individuals may experience a drop in temperature (hypothermia). A normal body temperature is around 98.6째F (37째C), but during sepsis, it can rise above 100째F (37.7째C) or fall below normal levels. These temperature changes occur as the body attempts to fight off the infection causing sepsis.

Infection: The Root Cause of Sepsis

What types of infections can lead to sepsis. Sepsis always stems from an underlying infection, which can be localized or generalized. Common sources include:

• Urinary tract infections (UTIs)
• Pneumonia
• Infected wounds or cuts
• Post-surgical infections

It’s important to note that sometimes the infection may not be immediately apparent, especially in individuals who have recently undergone surgery or invasive medical procedures.

Mental Decline: Cognitive Changes in Sepsis

How does sepsis affect mental status. Sepsis can significantly impact a person’s mental state, causing:

• Confusion
• Sleepiness or difficulty in rousing
• Worsening of existing dementia symptoms

These cognitive changes are particularly common in elderly patients and may be the primary indicator of sepsis in some cases.

Extremely Ill: Severe Discomfort and Breathing Difficulties

What are the most severe symptoms of sepsis. Patients with sepsis often report feeling extremely ill, experiencing:

• Severe pain or discomfort
• Shortness of breath
• A sense of impending doom

Many sepsis survivors describe their experience as the worst they have ever felt, with symptoms far more intense than typical illnesses.

Diagnosing Sepsis: Clinical Indicators and Laboratory Tests

How do healthcare professionals diagnose sepsis. Diagnosing sepsis involves a combination of clinical observations and laboratory tests. Healthcare providers look for specific signs and symptoms across four main categories:

Inflammatory Markers

What inflammatory markers indicate sepsis. The following inflammatory indicators are often elevated in sepsis:

• High white blood cell count
• Presence of immature white blood cells in circulation
• Elevated plasma C-reactive protein (CRP)
• Increased procalcitonin (PCT) levels

Hemodynamic Changes

How does sepsis affect the cardiovascular system. Sepsis can cause significant changes in blood flow and heart function, including:

• Low blood pressure (hypotension)
• Reduced central venous or mixed venous oxygen saturation
• Elevated cardiac index

Organ Dysfunction

What organ systems are affected by sepsis. Sepsis can lead to multiple organ dysfunction, manifesting as:

• Low oxygen levels in the blood
• Decreased urine output
• Elevated blood creatinine levels
• Abnormal blood clotting
• Absent bowel sounds
• Low platelet count
• High bilirubin levels

Tissue Perfusion Issues

How does sepsis affect tissue oxygenation. Poor tissue perfusion in sepsis is indicated by:

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

Treatment Approaches for Sepsis: From Early Intervention to Intensive Care

How is sepsis treated. The treatment of sepsis varies depending on several factors, including the affected area, the cause of infection, the organs involved, and the extent of damage. Early recognition and prompt treatment are crucial for improving outcomes.

Emergency Treatment and Intensive Care

When is intensive care necessary for sepsis patients. Patients with severe sepsis or septic shock require emergency treatment or admission to an intensive care unit (ICU). This level of care is necessary when:

• The sepsis is severe and rapidly progressing
• The patient develops septic shock, characterized by dangerously low blood pressure
• Multiple organ systems are affected

ICUs provide advanced life support, allowing medical staff to focus on treating the underlying infection while supporting vital organ functions.

Antibiotic Therapy: The Cornerstone of Sepsis Treatment

Why are antibiotics crucial in sepsis treatment. Antibiotics are the primary treatment for sepsis, severe sepsis, and septic shock. They are administered intravenously to ensure rapid distribution throughout the body. Key points about antibiotic therapy in sepsis include:

• Treatment should ideally begin within one hour of diagnosis
• Initial treatment often involves broad-spectrum antibiotics
• Once the specific pathogen is identified, more targeted antibiotics may be used
• Intravenous antibiotics are typically replaced by oral medications after 2-4 days
• The duration of antibiotic treatment ranges from 7-10 days or longer, depending on the severity of the condition

Managing Viral Sepsis

How is sepsis treated when caused by a virus. In cases where sepsis is caused by a viral infection, the approach differs slightly:

• Antibiotics are often administered initially due to the urgency of treatment, even though they are ineffective against viruses
• The patient’s immune system plays a crucial role in fighting the viral infection
• Antiviral medications may be prescribed in certain cases

Fluid Resuscitation in Sepsis Management

Why is fluid management important in sepsis treatment. Intravenous fluid administration is a critical component of sepsis treatment. Sepsis patients often require significant amounts of fluids due to:

• Increased fluid needs to support organ function
• Fluid losses from fever, vomiting, or diarrhea
• The need to maintain adequate blood pressure and organ perfusion

Sepsis in Special Populations: Children and the Elderly

How does sepsis presentation differ in children and older adults. Recognizing sepsis in certain populations can be challenging due to atypical presentations:

Sepsis in Children

What are the unique features of sepsis in pediatric patients. Children with sepsis may exhibit different symptoms compared to adults:

• Rapid breathing or difficulty breathing
• Bluish or pale skin
• Lethargy or difficulty waking
• Irritability or excessive crying
• Poor feeding in infants
• Seizures

Sepsis in the Elderly

Why is sepsis often overlooked in older adults. Elderly patients may not display typical signs of infection or sepsis. Instead, they may present with:

• Sudden changes in mental status
• Worsening confusion or dementia
• Decreased mobility
• Falls
• Loss of appetite

Preventing Sepsis: Strategies for Reducing Risk

How can the risk of developing sepsis be minimized. While it’s not always possible to prevent sepsis, certain strategies can help reduce 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
• Following prescribed antibiotic regimens completely

Long-term Effects of Sepsis: Understanding Post-Sepsis Syndrome

What are the potential long-term consequences of surviving sepsis. While many people recover fully from sepsis, some survivors experience long-lasting effects known as post-sepsis syndrome (PSS). Symptoms of PSS may include:

• Persistent fatigue and weakness
• Cognitive difficulties, including memory problems
• Anxiety and depression
• Muscle and joint pain
• Increased susceptibility to infections
• Sleep disturbances

Recovery from PSS can take months or even years, and some individuals may require ongoing support and rehabilitation.

Advancing Sepsis Research: Current Trends and Future Directions

What are the latest developments in sepsis research. The field of sepsis research is rapidly evolving, with several promising areas of investigation:

Biomarker Discovery

How can biomarkers improve sepsis diagnosis and treatment. Researchers are working to identify new biomarkers that could:

• Enable earlier and more accurate diagnosis of sepsis
• Predict sepsis severity and patient outcomes
• Guide personalized treatment approaches

Immunomodulation Therapies

Can modulating the immune response improve sepsis outcomes. Studies are exploring various immunomodulatory approaches, including:

• Therapies to boost the immune system in immunosuppressed patients
• Treatments to dampen excessive immune responses in hyperinflammatory states
• Targeted interventions to restore immune balance

Precision Medicine in Sepsis

How can personalized medicine improve sepsis treatment. The concept of precision medicine in sepsis aims to tailor treatments based on individual patient characteristics, including:

• Genetic factors influencing sepsis susceptibility and response to treatment
• Molecular profiling to guide antibiotic selection and duration
• Personalized fluid resuscitation strategies

Artificial Intelligence and Machine Learning

What role can AI play in sepsis management. Advanced computational techniques are being applied to sepsis research and clinical practice:

• Developing predictive models for early sepsis detection
• Optimizing treatment protocols based on real-time patient data
• Enhancing decision support systems for healthcare providers

As research in these areas progresses, it is hoped that new insights and innovations will lead to improved outcomes for sepsis patients, reducing mortality rates and enhancing quality of life for survivors.

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.