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.

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.

Products & Services

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.

What is sepsis and septic shock

Sepsis is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency. Without prompt treatment, this condition can lead to tissue damage, organ failure, and death.

Septic shock is the most severe form of sepsis and is difficult to treat.

Sepsis occurs when an infection already in the body causes an overreaction. Any infection can lead to sepsis: most often bacterial, but also fungi, such as Candida and viruses can also be the cause, although this is rare.

Sepsis can start with a small cut where bacteria can get in. Sometimes it occurs in people who didn’t even know they had some kind of infection.

Infections that most often lead to sepsis:

• pneumonia;
• infections of the kidneys and urinary system;
• infections of the digestive system;
• infections of wounds, burns or catheter sites.

It is believed that sepsis develops due to an infection that people caught in the hospital, for example after surgery. This can indeed happen, but statistics show that up to 87% of sepsis cases begin with infections that people have contracted at work, at school or at home.

Although anyone with an infection can get sepsis, some people are at higher risk:

• older people aged 65 or older;
• people with chronic diseases such as diabetes, lung disease, cancer and kidney disease;
• people with weakened immune systems;
• people with a history of sepsis, hospitalization, or severe illness;
• pregnant women;
• children under one year of age.

Symptoms of sepsis may appear suddenly. Among them:

• irregular breathing;
• rapid heartbeat or weak pulse;
• confusion and disorientation in time, place, self;
• severe pain and discomfort;
• fever, chills or feeling very cold;
• clammy and sweaty skin.

Sepsis often develops in people who are already in the hospital. But even outside the clinic, you should be attentive to your symptoms. Call your doctor if you have infections or wounds that don’t heal for a long time, or if you have any of the symptoms listed above.

To diagnose sepsis, doctors check for:

• fever;
• low blood pressure;
• increased heart rate;
• difficult breathing.

Health care providers also do tests to check for infection or organ damage. Some research is helping to find the microbe that caused the infection that led to sepsis. Tests may include:

• blood test, including procalcitonin – this protein is practically not detected in the blood of healthy people, but doctors detect high concentrations with a bacterial infection;
• urine or stool test;
• respiratory secretion testing – examining a sample of saliva, sputum or mucus;
• wound culture testing, in which a small sample of tissue, skin, or fluid is taken from an affected area for testing;
• imaging studies such as X-ray, ultrasound, CT or MRI.

Sepsis can be difficult to diagnose. Its symptoms can sometimes be similar to those of other illnesses, such as the flu or a lung infection.

It is important that sepsis treatment is started as early as possible to increase the chances of recovery. The likelihood of progression from sepsis to septic shock increases by 4–9% for every hour of delay in treatment.

People with sepsis require constant monitoring and treatment in the intensive care unit of a hospital. Life-saving measures may be required to stabilize breathing and heart function.

Treatment of sepsis usually requires intravenous fluids, antibiotics, and vasopressors, drugs that constrict blood vessels and increase blood pressure. Sometimes surgery is done to remove tissue damaged by the infection.

Sepsis may not immediately progress to septic shock, there is an intermediate condition called severe sepsis. Severe sepsis occurs when one or more organs stop working properly. For example, when a person needs a ventilator to breathe or dialysis to filter toxins from the blood.

Septic shock occurs when blood pressure drops dangerously low due to sepsis.

In order for blood to deliver oxygen and nutrients to organs and tissues, a certain pressure is created in the blood vessels, which helps the heart to pump blood. The average blood pressure for a healthy adult is about 120/80 mmHg. Art. Low blood pressure – below 90/60 mmHg Art. This pressure can affect the heart’s ability to pump blood, which means blood can’t reach vital organs like the brain and liver. This can lead to organ damage or death.

Septic shock is a medical emergency. Treatment for septic shock is aimed at raising blood pressure, eliminating the infection that caused the sepsis, and supporting organs that can no longer do their job.

The surest way to prevent sepsis is to prevent infections that can cause it. Here’s what you need:

Symptoms and treatment of sepsis – articles by specialists of the ITC MVA

Likhacheva O.V. – Veterinarian of the Therapy Department of the ITC MVA.

Sepsis is a systemic inflammatory reaction to an infectious process when the body cannot localize it.

Septic shock is the end stage of sepsis.

Conditions such as trauma, burns, systemic neoplasia, tissue ischemia have a similar course and their final stages do not differ from sepsis and are designated by one term – systemic inflammatory response syndrome (SIRS – systemic inflammatory response Syndrome).

Sepsis is caused by bacteria and fungi. Most often it is streptococci, staphylococci, Escherichia coli.
The leading symptoms are a significant increase or decrease in body temperature, shortness of breath, tachycardia, leukocytosis or leukopenia.

According to modern concepts, the pathogenesis of sepsis development is presented as follows :

The body reacts to the introduction of an infectious agent by activating the immune system. Initially, this is a local reaction to injury or infection. With an increase in the inflammatory reaction, cytokines (inflammatory mediators) are released into the blood, where, due to the balance between them and endogenous antagonists, conditions are created to suppress microorganisms. With the generalization of the inflammatory process, the regulatory systems are no longer able to maintain homeostasis, and the destructive activity of cytokines and other inflammatory mediators is manifested. There is an expansion of the vessels of the arterial and venous bed, an increase in the permeability of capillaries. In this stage, there is an increase in cardiac output, hyperemia of the mucous membranes, tachycardia. As a rule, the filling rate of capillaries is less than 2 seconds. This is the hyperdynamic phase of septic shock, which, without therapeutic intervention, passes into the hypovolemic phase.

It is characterized by the release of plasma into the intercellular space through the damaged endothelial layer of the vessels, which can be symptomatically established by the cold peripheral parts of the body, pale gray mucous membranes and poorly filled pulse. The body experiences severe hypoxia. This increases blood viscosity and thrombosis. Disseminated intravascular coagulation develops – DIC syndrome.

The end stage of SIRS is multiple organ failure, which significantly worsens the prognosis.

Symptoms of sepsis are not specific, therefore, if sepsis is suspected, it is necessary to stop the main cause of inflammation, most often it is abscesses, purulent inflammation of the uterus (pyometra), wounds, peritonitis, urinary tract infections, surgical treatment of the focus of infection, if possible, and start the use of antibacterial drugs, after taking an analysis for cytological and bacteriological examination.

If the inflammatory focus is not found, we give a bacteriological analysis of blood and urine. Often the cause of infection is localized in the abdominal cavity. To study it, radiography and ultrasound diagnostics are used. With deep biting, bullet wounds, with blunt trauma, diagnostic abdomenocentesis or diagnostic peritoneal lavage is used.