What is a septic infection in the body? Discover the causes, symptoms, and prevention of bacterial infections that can lead to sepsis. Learn about the different types of septic infections and how to recognize the signs of a medical emergency.

Bacterial Infections and Sepsis: An Overview

Bacteria are microscopic single-cell microorganisms that are found all around us. While many bacteria are harmless or even beneficial, some types can cause bacterial infections that can lead to a life-threatening condition called sepsis. Sepsis is the body’s often deadly response to an infection, and it requires rapid diagnosis and treatment.

Sepsis can result from an infection anywhere in the body, such as pneumonia, influenza, or a urinary tract infection. Bacterial infections are the most common cause of sepsis, and worldwide, one-third of people who develop sepsis die. Even those who survive can be left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction, and amputations.

How Do Bacterial Infections Occur?

Bacteria must enter the body to cause an infection. This can happen through an opening in the skin, such as a cut, bug bite, or surgical wound. Bacteria can also enter the body through the airway and cause infections like bacterial pneumonia. Other types of bacterial infections include urinary tract infections (including bladder and kidney infections), dental abscesses, and infections caused by MRSA, Group B Streptococcus, and C. Difficile. Infections can also occur in open wounds, such as pressure ulcers (bed sores).

Sometimes, bacterial infections are “secondary infections.” For example, if you contract COVID-19 – a viral infection – your body may be in a weakened state, and you could also develop bacterial pneumonia, fighting both a viral and a bacterial infection.

Symptoms of Bacterial Infections

Bacterial infections can present in many ways, depending on the part of the body affected. Common symptoms include fever, chills, pain or discomfort in the affected area, and other symptoms specific to the type of infection. For example, if you have bacterial pneumonia, you may experience fever, cough with phlegm, shortness of breath, sweating, and chest pain with breathing. If you have a urinary tract infection, you may have sudden and extreme urges to void, burning or pain during urination, and a feeling of not emptying your bladder completely.

Preventing Bacterial Infections

While not all infections can be prevented, the chances of spreading bacterial infections can be greatly reduced by following these tips:

• Wash your hands often, particularly if you are in a healthcare facility.
• Keep wounds clean and covered.
• Avoid sharing personal items, such as razors.

Treating Bacterial Infections

Most often, treatment for a bacterial infection involves the use of antibiotics, which can be taken orally, by injection, drops, topical application, or intravenously. The duration of treatment can range from very short to several weeks, depending on the type of infection and how it responds to the antibiotics. If the infection does not go away, your doctor may try a different type of antibiotic.

If you suspect sepsis, it is essential to call 9-1-1 or go to a hospital immediately and inform the medical professional that you are concerned about sepsis. Sepsis is a medical emergency that requires rapid diagnosis and treatment.

Sepsis: A Life-Threatening Condition

Sepsis can be caused by bacterial, viral, or fungal infections, but most cases of sepsis are the result of bacterial infection. Sepsis is a full-body response to bacteremia, which is the presence of bacteria in the blood.

Elderly people and people with other medical conditions are at higher risk of getting sepsis than the general population. The main symptoms of sepsis include fever, chills, confusion, rapid pulse, and drowsiness. Sepsis needs to be treated urgently in a hospital, and the treatment typically involves antibiotics and fluids.

Septicemia, SIRS, and Septic Shock

The term septicemia is sometimes used interchangeably with sepsis, but it technically refers to the presence of bacteria in the bloodstream. Septicemia is a specific type of sepsis.

SIRS, or systemic inflammatory response syndrome, is a broader term that encompasses the body’s response to various types of insults, including infections, trauma, and other conditions. Sepsis is a type of SIRS that is specifically caused by an infection.

Septic shock is a severe form of sepsis that involves extremely low blood pressure and organ dysfunction. Septic shock is a medical emergency that requires immediate treatment to prevent death.

In summary, understanding the causes, symptoms, and prevention of bacterial infections is crucial, as these infections can lead to the life-threatening condition of sepsis. Recognizing the signs of sepsis and seeking immediate medical attention can be the difference between life and death.

Bacterial Infections – Sepsis Alliance

Bacteria are microscopic single-cell microorganisms that are found all around us. Most of them are harmless and many are helpful. For example, bacteria in your intestines (gut) help break down the food you eat so your body can digest it. However, some types of bacteria can cause bacterial infections, which in turn can cause sepsis.

Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Bacterial infections are the most common cause of sepsis. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.

Examples of bacterial infections

Bacteria must enter your body for them to cause an infection. So you can get a bacterial infection through an opening in your skin, such as a cut, a bug bite, or a surgical wound. Bacteria may also enter your body through your airway and cause infections like bacterial pneumonia. Other types of bacterial infections include urinary tract infections (including bladder and kidney infections) and dental abscesses, as well as infections caused by MRSA, Group B Streptococcus, and C. Difficile. Infections can also occur in open wounds, such as pressure ulcers (bed sores). Pressure ulcers are caused by constant pressure on the skin for extended periods of time, or rubbing. For example, a senior who is bedridden, could develop sores on the coccyx (tailbone) area, elbows, heels, or anywhere else where there is constant contact with a bed or adapted “easy chair.”

Sometimes bacterial infections are “secondary infections. ” For example, if you contract COVID-19 – which is a virus – your body is in a weakened state and you could also develop bacterial pneumonia. You would then be fighting both a viral infection and a bacterial one.

What are the symptoms of a bacterial infection?

Bacterial infections present in many ways, depending on the part of the body affected. If you have bacterial pneumonia, you may experience

• Fever
• Cough, with phlegm
• Shortness of breath
• Sweating
• Shaking chills
• Headache
• Muscle pain
• Fatigue
• Chest pain with breathing

If you have a urinary tract infection, you may have some of these symptoms:

• Sudden and extreme urges to void (pass urine)
• Frequent urges to void
• Burning, irritation or pain as you void
• A feeling of not emptying your bladder completely
• A feeling of pressure in your abdomen or lower back
• Thick or cloudy urine – it may contain blood
• Fever

The common element with most bacterial infections are:

• Fever
• Chills
• Pain or discomfort in the affected area

But if the infection is in a joint, that joint and the surrounding area will likely hurt; if you have a sinus infection, you will probably have a headache and foul nasal discharge, and so on.

Prevention

Not all infections can be prevented, but the chances of spreading bacterial infections can be greatly reduced by following these tips:

• Wash your hands often, particularly if you are in a healthcare facility.
• Keep wounds clean and covered.
• Avoid sharing personal items, such as razors.

Treatment

Most often, treatment for a bacterial infection is with antibiotics. They could be taken orally (by pill, liquid or capsule), injection, drops, topical (cream or ointment), or intravenously (by IV). The treatment may be very short or it could go as long as several weeks, depending on the type of infection and how it reacts to the antibiotics. Sometimes, the infection will not go away and your doctor may have to try a different type of antibiotic.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis. 2]

Sepsis can be caused by bacterial, viral, or fungal infections. Most cases of sepsis are the result of bacterial infection. As a result, sepsis can be defined as a full-body response to bacteremia, which is the presence ofbacteria in the blood.

Elderly people and people with other medical conditions are at higher risk of getting sepsis than the general population. The main symptoms include fever, chills, confusion, rapid pulse and drowsiness. Sepsis needs to be treated urgently in a hospital and is treated with antibiotics and fluids.

Septicemia, SIRS, and septic shock

The term septicemia is often used as a synonym for sepsis, but medically speaking, they are separate, though related, conditions. Technically, septicemia is an infection of the blood, while sepsis affects the body as a whole.

Sepsis has also been known as SIRS, or Systemic Inflammatory Response Syndrome, but this term is now considered to be out of date. 5]

Symptoms of sepsis

Symptoms of sepsis include:

• Fever or feeling cold
• Chills
• A strong feeling of illness
• Drowsiness
• Fast pulse
• Fast breathing
• Confusion

As the sepsis gets worse, people may have very cold and blue hands and feet, urinate less and lose consciousness altogether. There may also be signs of the underlying infection. These signs can vary greatly, depending on factors, including where the infection has begun and what kind of infectious agents it is caused by, and can include:

• Abdominal pain
• Coughing
• An abscess
• Jaundice
• Painful urination

Good to know: In some people, especially children, infants and the elderly, the symptoms of sepsis may be vague and non-specific. It is important to seek medical help immediately if sepsis is suspected. If an affected person is known to have recently had an infection or to have an infection currently, sepsis should be considered a possibility, and medical help should be found as soon as possible. 5]

• Fever, defined as a body temperature of above 38 C / 100.4 F, with or without chills
• Low body temperature, usually defined as below 36 C / 96.8 F
• Cold extremities, which may also be bluish or mottled
• Sweating
• Rapid breathing
• Rapid heartbeat
• Mental confusion, grogginess, lack of alertness, or unresponsiveness
• Cold and warm shock

In warm shock, the skin becomes warms and the heart rate increases. This is due to increased cardiac output making the arteries dilate, increasing blood pressure.

In cold shock, which follows, the cardiac output decreases. Correspondingly, the blood pressure drops, and the skin becomes chill, mottled, pale, bluish and/or clammy.

If you’re concerned that you might have a serious infection or are developing sepsis, you can do a free symptom assessment using the Ada app at any time.

Symptoms of sepsis in babies and children

The symptoms of sepsis can be different in children. It is important to remember that young children may not be able to tell caregivers whether they feel ill or how ill they feel. Children, toddlers and infants with sepsis may:

• Feel unusually cold to the touch
• Have blotchy, blue, pallid and/or clammy skin
• Have a rash that does not fade when pressed
• Breathe rapidly
• Be unwilling to eat or take feeds
• Vomit or complain of nausea
• Produce very little or no urine
• Be difficult to wake up or rouse

If you are at all concerned that your infant or a child in your care may have sepsis, it is best to take them to a doctor as soon as possible. If you are concerned that your child or a child in your care might have an infection, you can do a free symptom assessment at any time using the Ada app.

Neonatal sepsis

Newborn babies are vulnerable to neonatal sepsis, a condition which results from an infection occurring during the early days of life. Neonatal sepsis usually results from a bacterial infection. There are two main types of neonatal sepsis:

• Early onset neonatal sepsis, which occurs within the first three days of life and is usually the result of an infection picked up from the infant’s mother during or before birth. Symptoms of early onset neonatal sepsis can appear within six hours of birth.
• Late onset neonatal sepsis, which occurs between the ages of four days and three months, is usually the result of an infection picked up from the environment, such as the clinic or hospital.

Good to know: While most cases of neonatal sepsis are caused by bacterial infections, it is also possible for viral infections to lead to the disorder. The herpes simplex virus, enterovirus and adenovirus have all been found to cause neonatal sepsis.

Factors that increase a baby’s risk of developing early-onset neonatal sepsis include:

• A Group B streptococcal infection in the mother
• Preterm delivery
• The mother’s waters breaking more than 18 hours before the baby is born
• Chorioamnionitis, an infection of the placenta and amniotic fluid

Factors that increase a baby’s risk of late onset neonatal sepsis include:

• A long stay in hospital after birth
• A catheter or in-dwelling IV line
• Use of antibiotics

Signs and symptoms of neonatal sepsis

The signs of neonatal sepsis are not always very obvious, and caregivers of at-risk babies should be vigilant. Symptoms of neonatal sepsis include:

• Lethargy, or less activity than usual
• Reluctance to suckle, or loss of interest in suckling
• Loss of appetite
• Apnea, a temporary pause in breathing
• Slow heartbeat
• Fever or low body temperature
• Changes in bowel movements, for example diarrhea or constipation
• Seizures
• Vomiting
• Jaundice

Good to know: As with other forms of sepsis, early detection and prompt treatment greatly improve the chances of a good outcome in babies with neonatal sepsis. If you are concerned that your baby may have an infection, consult your health provider as soon as possible.

Risk Factors and Causes

Elderly people are at higher risk of developing sepsis, though it can affect people of every age. People with some medical conditions, such as cancer, a weakened immune system or diabetes, are at increased risk of this condition. Sepsis occurs when an infection spreads from a particular location into the blood; for example, from the lungs, the bladder or the skin. This causes a whole-body response, as the immune system tries to fight the infection.

Some groups of people are at higher risk of developing sepsis than others. These groups include:

• People older than 75 years of age or children younger than one year of age
• People who have diabetes mellitus
• People who have recently had surgery or invasive medical procedures
• People who have recently sustained severe burns
• People who have in-dwelling IV lines or catheters
• People who take high doses of steroids
• Users of intravenous recreational drugs
• People who use excessive alcohol
• People who have cirrhosis of the liver
• People with weakened immune systems, for example as a result of HIV infection or chemotherapy
• Pregnant women

This list is not exhaustive, and it is possible for any person to develop sepsis. If you are concerned that your or a loved one may have sepsis, you can do a free symptom assessment using the Ada app at any time.

Underlying conditions

Sepsis arises following an infection or injury to the body. The gastrointestinal tract, the genitourinary tract, soft tissue, the skin, the pelvic area and the the respiratory system are all common sites of infections that can progress to sepsis.

There are many conditions affecting the renal and genitourinary systems, which can lead to sepsis. These include:

Good to know: Sepsis affecting the urinary system is often known as urosepsis.

Conditions affecting the gastrointestinal system, which can lead to sepsis include:

Conditions affecting the respiratory system, which can lead to sepsis include:

• Pneumonia
• Pleural empyema, a condition in which a bacterial infection causes pus to collect in between the pleural membranes that surround the lungs
• Lung abscess
• Influenza

Conditions affecting other systems and structures in the body, which can lead to sepsis include:

Good to know: Just having one of the above conditions does not mean that the affected individual will develop sepsis. Most people who get bacterial infections do not develop sepsis. However, some people are more vulnerable to developing sepsis than others.

In addition, some medical procedures and devices can increase the risk of developing sepsis:

• Open surgery
• Prosthetic heart valves
• Long-term catheters
• Long-term intravenous lines
• Breathing tubes and intubation
• Recent use of antibiotics
• Recent use of high-dose steroids
• Chemotherapy

Bacteria involved in sepsis

Not all bacteria can cause sepsis. The species of bacteria most commonly responsible for sepsis include:

• Methicillin-resistant staphylococcus aureus (MRSA)
• Group B streptococcus
• Staphylococcus pyogenes
• Klebsiella
• Escherichia coli
• Pseudomonas aeruginosa

Good to know: Toxic shock syndrome, which is caused by Group A Streptococcus and Staphylococcus aureus, is not the same as sepsis but can lead to sepsis. For more information on toxic shock syndrome, see the FAQs.

When someone with suspected sepsis is examined by a doctor, the exact strain of bacteria responsible for their sepsis may not be known. The first line of treatment, therefore, is to administer a broad-spectrum antibiotic. For more information, see the section on treatment.

Diagnosis of sepsis

Diagnosis is often made from the appearance and physical examination of the affected person. Blood tests are taken to prove that an infection is the cause of the symptoms, to check the function of organs that might be affected by sepsis and to identify the cause of sepsis. Sepsis screening is an important part of the diagnostic process.

Sepsis screening

SOFA: Sepsis-related Organ-Failure Assessment score

The SOFA score is used to determine how severely ill a person affected by sepsis is and assesses the risk of mortality. The SOFA score is determined by measuring organ function in the respiratory, cardiovascular, liver, kidney and neurological systems, as well as blood coagulation. 5]

Both SOFA and qSOFA tests have to be carried out by trained medical professionals in a medical setting.

Blood and laboratory tests

Blood tests and bacterial cultures are an important part of diagnosing sepsis. Blood tests that are usually carried out include:

• A complete blood count to identify clotting abnormalities and count the white blood cell levels
• Laboratory cultures of the blood, to determine which bacterial species isbacteria are responsible for the sepsis and thereby guide antibiotic therapy.

Sometimes cultures are also carried out using samples of pus, nasal mucus, urine or phlegm, depending on the type of suspected underlying infection.

Read more about Blood Test Results »

Imaging tests

In cases where an abscess or localised infection is suspected to be the cause of sepsis, imaging studies may be carried out to aid diagnosis and treatment. Imaging tests commonly carried out during the diagnosis of sepsis include:

• Chest X-rays to identify pneumonia or lung disorders
• Abdominal ultrasound
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)

Treatment

Sepsis is a life-threatening condition which must be treated in a hospital. The key to successfully treating sepsis is to diagnose it as early as possible and thereafter to begin aggressive antibiotic and supportive treatment as soon as possible.

Sepsis is treated by giving antibiotics against the cause of the infection and fluids to increase blood pressure. The cause of the original infection should be identified and treated, or removed.

Hospital care for sepsis

Most people with sepsis will require hospitalization, and people who are severely affected may need to be treated in an Intensive Care Unit (ICU). Upon being admitted to hospital, the affected person will be given oxygen, breathing support, and vasopressors and fluids to support blood pressure and organ function.

In some cases, intravenous insulin may also be given to support blood glucose levels. While hospitalized, the affected person will be tested for inflammation markers, often several times a day, to monitor their condition. The duration of the stay in hospital will depend on the severity of the sepsis, the effectiveness of the treatment and the management of the underlying condition.

Antibiotic treatment

Because most cases of sepsis are the result of a severe bacterial infection, antibiotic treatment is one of the first lines of treatment against the disorder. Initial treatment with antibiotics is begun even before the pathogen responsible is identified, using a broad-spectrum antibiotic. Thereafter, the treatment will be adjusted according to what laboratory cultures identify as the cause of the infection.

Surgical procedures

If the sepsis has been identified as the result of an abscess, burns or an infected surgical incision or wound, surgical procedures may be needed to remove the source. In the case of an abscess, the abscess will need to be surgically drained. In other cases, such as burns or infected wounds, the affected tissue may need to be removed, along with any foreign objects.

Complications and long-term prognosis

Sepsis is a serious condition that needs to be treated promptly and aggressively to ensure a good outcome. There are several complications associated with sepsis, as well as a number of long-term effects which may impact the quality of life of people who have had the condition.

Waterhouse-Friderichsen syndrome

Waterhouse-Friderichsen syndrome is a rare complication, a condition in which the adrenal glands fail due to bleeding. The syndrome causes bleeding inside the adrenal glands and, because of the damage to the adrenal glands this causes, to adrenal insufficiency.

Symptoms include:

• A rash, beginning as small pink patches or swellings that resemble pimples, which later expand into larger purple patches
• Malaise and weakness
• Dizziness
• Cough
• Joint and muscle pain
• Fever
• Rigors/chills
• Nausea and vomiting
• Headache
• Low blood pressure
• Fast heart rate

Good to know: Most cases are caused by severe infection with meningococcal bacteria, Group B streptococcus, Streptococcus aeruginosa, Staphylococcus pneumoniae or Staphylococcus aureus.

Waterhouse-Friderichsen Syndrome is a medical emergency, and anyone who shows symptoms of the syndrome should receive medical care immediately.

Disseminated intravascular coagulation

Sepsis can disturb the processes that control the blood’s clotting. As a result, disseminated intravascular coagulation can occu, and may be serious. In this condition, blood clots form throughout the body, and, as the chemicals that help blood to clot become depleted, bleeding occurs. This condition can lead to organ dysfunction and organ failure.

Long-term changes to quality of life: post-sepsis syndrome

Sepsis, because of its severity and the effects it has throughout the body, can cause after-effects of various kinds. These include:

• Post-traumatic stress disorder
• Amputations
• Rehospitalization due to infection
• Relapse of sepsis
• Cognitive problems such as confusion
• Cardiovascular problems
• Muscle and joint pain
• Insomnia and nightmares, or other sleep disorders
• Anxiety and depression

Together, these make up post-sepsis syndrome, a condition which affects almost 50% of all sepsis survivors, particularly if they are older adults. People who were admitted to an ICU with sepsis may be more likely to have post-sepsis syndrome.

Prevention

It is important that infections, such as pneumonia, bladder infections or skin infections, are assessed early by a doctor and treated with antibiotics. People who are at increased risk of vaccine-preventable infections, such as the elderly and people with other medical conditions, should make sure they keep their vaccinations up to date.

Sepsis FAQ

Q: Is sepsis fatal?
A: Sepsis can be fatal. It is one of the most common causes of death among hospitalized people. However, improvements in care have reduced mortality rates in recent decades, and early detection and prompt appropriate treatment further improves the outcome.

Q: Is sepsis contagious?
A: No, sepsis is not contagious – it cannot spread from person to person. However, the underlying infection that has caused the sepsis may be contagious.

Q: Can sepsis cause red streaks on the skin?
A: Red streaks on the skin spreading from the site of an infected wound are a sign that the infection has spread to the lymph vessels. Red streaks are not a sign of sepsis itself, but can indicate that a skin infection such as erysipelas or cellulitis has begun in the affected area. If left untreated, both erysipelas, which affects the upper layers of the skin, and cellulitis, which affect deeper layers of tissue, can potentially lead to sepsis.

Q: Can sepsis cause a skin rash?
A: Yes, it can. Some people with sepsis develop a hemorrhagic rash, which in its early stages looks like a cluster of small red dots, but can develop into larger spots that resemble bruises.

Q: What is toxic shock syndrome and how does it differ from sepsis?
A: Toxic shock syndrome (TSS) is a disorder caused by toxins produced by Staphylococcus aureus and/or Group A Staphylococcus. Toxic shock syndrome can lead to sepsis. It often results from infections affecting the skin, surgical wounds, abscesses, and sinus and bone infection.

Toxic shock syndrome has a sudden onset and can quickly become medically serious. TSS is potentially life-threatening and should be considered a medical emergency.
The symptoms of TSS include:

• Fever of 38.8 C / 102 F or higher
• Pain
• Rapid, sudden drop in blood pressure
• Confusion
• Fainting
• Headache
• Diarrhea and vomiting
• Low or no urine output
• Fatigue and weakness
• Difficulty breathing
• Rash

Q: What is Systemic Inflammatory Response Syndrome?
A: SIRS is a concept used to determine whether an affected person has sepsis, not a separate condition. An affected person is considered to have sepsis if they meet two or more of the SIRS criteria, which are:

• Fever of 38 C / 100. 4 F or more
• Hypothermia of 36 C / 96.8 F or less
• A pulse of more than 90 beats a minute
• Rapid breathing, of more than 20 breaths a minute
• An increase or decrease in the number of white blood cells in the blood, determined using a blood tests

In recent years, the medical communities have moved away from using it because it is no longer considered to be sufficiently sensitive or accurate. Most medical practitioners now use the qSOFA Score system to determine whether sepsis is present.

Q: Can influenza cause sepsis?
A: Although most cases of sepsis are the result of bacterial infection, it is possible for a viral infection to lead to sepsis. Influenza is a viral infection. However, it is rare for influenza itself to cause sepsis.

Septic Shock: Symptoms, Signs, Risks, and Treatment

Our immune system protects our bodies from a variety of things, including viruses, bacteria, and toxins, so having a healthy one is important. Sometimes, however, an immune system can weaken or fail. It can even work against us, causing autoimmune disorders, which can put one at greater risk for sepsis and lead to septic shock.

What is Sepsis?

Sepsis, also known as septicemia or blood poisoning, occurs when the body has a severe response to an infection. Instead of the immune system defending the body, it releases chemicals, potentially leading to  mass inflammation and damage to the kidneys, lungs, liver, or other major organs.

The body is vulnerable to a number of things, but sepsis is typically caused by bacterial infections, and most incidences of sepsis occur in people who are or have recently been hospitalized Those individuals are at risk of contracting sepsis through wounds or incision sites, bed sores, catheters, and IV lines.

Sepsis symptoms include:

• Fast heartbeat
• Extremely low body temperature
• Fever and chills
• Sweaty or clammy skin
• Decrease in urination
• Diarrhea
• Nausea and vomiting

If left untreated, sepsis can progress to septic shock.

What is Septic Shock?

Septic shock, the most severe stage of sepsis, ranks as one of the highest causes of death in ICUs in the United States each year.

Septic shock occurs when sepsis is left untreated and progresses to circulatory, cellular, and metabolic abnormalities. These include:

• Low blood pressure and/or high pulse rate; difficulty breathing with increasing oxygen requirement
• Lab abnormalities – kidney or liver dysfunction, blood count abnormalities
• Confusion or change in mental status

At this stage, immediate medical attention is critical.

What Are Septic Shock Symptoms?

Depending on a patient’s progression through the phases of sepsis, symptoms range from mild to severe. The most common symptoms include:

• Low blood pressure (Hypotension)
• Respiratory issues
• Confusion
• Temperature exceeding 101⁰ F
• Fever and chills
• Increased heart rate
• Organ failure
• Urological issues

Who is at Risk for Septic Shock?

“Older adults, immunocompromised individuals, and those who have existing medical conditions such as type 1 and type 2 diabetes are at higher risk for developing septic shock,” explains Dahlia Philips, MD, a Summit Health infectious diseases and travel medicine specialist.

People also can develop sepsis and septic shock from urinary tract infections and exposure to certain intravenous (IV) devices, urinary catheters, and breathing tubes. These medical devices can quickly introduce foreign bacteria into an already vulnerable body.

How to Detect Sepsis and Septic Shock

Diagnosis for sepsis and septic shock is generally made using a combination of blood tests and physical exam findings; however, there are other ways to determine infection progress, such as:

• X-rays
• MRIs
• CT scans
• Urinary tests
• Wound examinations

Can You Survive Sepsis and Septic Shock?

Sepsis and septic shock can cause dangerous and life-threatening complications and require immediate medical attention and treatment for the best prognosis. Chances of survival are greatly dependent on infection source and how far along infection has progressed, but thanks to early symptom recognition and treatment options, it can be survivable.

If you are concerned about your risk of sepsis, talk to your provider. If you don’t have a primary care physician, call 908-273-4300 or visit summithealth.com.

Infections Caused by Bacteria – Special Pet Topics

Bacteremia is the presence of bacteria in the bloodstream; sepsis, which is also called septicemia, is illness resulting from the persistence of microorganisms or their toxins in the bloodstream.

Temporary bacteremia may occur during dental procedures, because bacteria living on the gums around the teeth are freed and enter the bloodstream. Bacteria can also enter the bloodstream from the intestine, but they are rapidly removed when the blood passes through the liver. These transient events are usually not serious.

Sepsis is less common than bacteremia. Sepsis can develop when there is an infection somewhere in the body, such as the lungs, abdomen, or urinary tract. Sepsis can also occur when surgery is performed on an infected area or on a part of the body where bacteria normally live, such as the intestine. The presence of a foreign object, such as an intravenous line or a drainage tube, may increase the risk of sepsis, and the chance of sepsis increases the longer the object is left in place. Sepsis is more likely to develop in animals with a suppressed immune system or other immune disorder. Rarely, nonbacterial infections can cause sepsis.

The circulating bacteria may settle in sites throughout the body if treatment is not started quickly. An infection can develop in the tissues surrounding the brain (meningitis), the sac around the heart (pericarditis), the bones (osteomyelitis), the joints (infectious arthritis), and other areas. Certain types of bacteria, such as staphylococci, can result in accumulations of pus that form abscesses in the organs they infect.

Because the body is usually able to clear small numbers of bacteria quickly, temporary bacteremia rarely causes signs. When sepsis does develop, signs include shaking, fever, weakness, confusion, lack of appetite, vomiting, and diarrhea. Other signs can also be present depending on the type and location of the initial infection.

A sudden high fever in an animal that has an infection may indicate sepsis. Bacteria in the bloodstream are usually difficult to find by simply examining the blood under a microscope. Several blood samples may be needed to make the diagnosis; the samples are sent to a laboratory for culture, a procedure to try to grow the bacteria for specific identification. Blood cultures can take several days. Unfortunately, bacteria may not always grow in a blood culture, particularly if the animal is taking antibiotics. Cultures of other fluids and substances (such as urine, cerebrospinal fluid, wound tissue, and material coughed up from the lungs) may also be analyzed for the presence of bacteria.

Bacteremia caused by surgery or dental procedures usually does not require treatment. However, animals at risk of developing serious infections (such as those with heart valve disease or a weakened immune system) may be given antibiotics to prevent bacteria and sepsis before undergoing such procedures.

Sepsis is very serious and can lead to septic shock. Antibiotic treatment should begin immediately—even if test results confirming the diagnosis are not yet available. A delay in starting antibiotic treatment greatly decreases the animal’s chances of survival. Initially, one or more antibiotics are selected based on the bacteria most likely to be present, which depends on where the infection started. Often, 2 or 3 antibiotics that are effective against a broad range of bacteria are given together to increase the chances of killing the bacteria before the identity of the infectious agent is known. Later, when the test results become available, the antibiotic may need to be changed to one that is most effective against the specific bacteria causing the infection. Surgery may sometimes be needed to eliminate the source of the infection.

Septic shock | UF Health, University of Florida Health

Definition

Septic shock is a serious condition that occurs when a bodywide infection leads to dangerously low blood pressure.

Alternative Names

Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Causes

Septic shock occurs most often in the very old and the very young. It may also occur in people with weakened immune systems.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage. This may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.

The body has a strong inflammatory response to the toxins that may contribute to organ damage.

Risk factors for septic shock include:

• Diabetes
• Diseases of the genitourinary system, biliary system, or intestinal system
• Diseases that weaken the immune system, such as AIDS
• Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters, and plastic and metal stents used for drainage)
• Leukemia
• Long-term use of antibiotics
• Lymphoma
• Recent infection
• Recent surgery or medical procedure
• Recent or current use of steroid medicines
• Solid organ or bone marrow transplantation

Symptoms

Septic shock can affect any part of the body, including the heart, brain, kidneys, liver, and intestines. Symptoms may include:

• Cool, pale arms and legs
• High or very low temperature, chills
• Lightheadedness
• Little or no urine
• Low blood pressure, especially when standing
• Palpitations
• Rapid heart rate
• Restlessness, agitation, lethargy, or confusion
• Shortness of breath
• Skin rash or discoloration
• Decreased mental status

Exams and Tests

Blood tests may be done to check for:

• Infection around the body
• Complete blood count (CBC) and blood chemistry
• Presence of bacteria or other organisms
• Low blood oxygen level
• Disturbances in the body’s acid-base balance
• Poor organ function or organ failure

Other tests may include:

• A chest x-ray to look for pneumonia or fluid in the lungs (pulmonary edema)
• A urine sample to look for infection

Additional studies, such as blood cultures, may not become positive for several days after the blood has been taken, or for several days after the shock has developed.

Treatment

Septic shock is a medical emergency. In most cases, people are admitted to the intensive care unit of the hospital.

Treatment may include:

• Breathing machine (mechanical ventilation)
• Dialysis
• Drugs to treat low blood pressure, infection, or blood clotting
• High volume of fluids given directly into a vein (intravenously)
• Oxygen
• Sedatives
• Surgery to drain infected areas, if needed
• Antibiotics

The pressure in the heart and lungs may be checked. This is called hemodynamic monitoring. This can only be done with special equipment and intensive care nursing.

Outlook (Prognosis)

Septic shock has a high death rate. The death rate depends on the person’s age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started.

Possible Complications

Respiratory failure, cardiac failure, or any other organ failure can occur. Gangrene may occur, possibly leading to amputation.

When to Contact a Medical Professional

Go directly to an emergency department if you develop symptoms of septic shock.

Prevention

Prompt treatment of bacterial infections is helpful. Vaccination could help prevent some infections. However, many cases of septic shock cannot be prevented.

References

Russell JA. Shock syndromes related to sepsis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 100.

van der Poll T, Wiersinga WJ. Sepsis and septic shock. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 73.

Sepsis (Septic Shock) | HealthLink BC

Topic Overview

What is sepsis?

Sepsis is a life-threatening reaction to an infection. It causes inflammation across large areas of the body and can damage tissue and organs.

Sepsis requires immediate care in a hospital.

Septic shock is sepsis that causes extremely low blood pressure, which limits blood flow to the body. It can cause organ failure and death.

What causes sepsis?

Most of the time, sepsis is caused by a bacterial infection. A long-term or a sudden illness can cause sepsis. An injury or a reaction to surgery can also cause it.

Sepsis can occur in people of any age. But it is more common in infants, older adults, and people who have a compromised immune system that cannot fight infection. Sepsis can develop very quickly.

What are the symptoms of sepsis?

Sepsis causes a combination of symptoms. Symptoms may include breathing problems, a fast heartbeat, chills, cool clammy skin, skin rashes, and shaking. Other symptoms may include a fever or low body temperature, confusion, and low blood pressure.

If you are concerned about sepsis, go to the hospital immediately. Tell them you are concerned about sepsis.

How is sepsis diagnosed?

Your doctor will ask you about your symptoms and do tests, including blood tests. You may get an X-ray or CT scan to help find the infection.

How is it treated?

Doctors will treat sepsis with medicine to treat the infection. They will try to find the infection that led to sepsis.

Machines will track vital signs, including temperature, blood pressure, breathing rate, and pulse rate. You’ll get fluids through an IV and may get strong medicine to help raise your blood pressure.

You might need to be treated in an intensive care unit (ICU) for several days or longer. An ICU is a part of the hospital where very sick people get care.

Equipment in the ICU can support your body. That includes your breathing, circulation, fluids, and help for organs like the kidneys and heart. If you need help breathing, a ventilator may be used.

How can you prevent sepsis?

Here are some ways to help prevent infections that could lead to sepsis:

• Try to avoid colds and influenza (flu). If you are around people who have a cold or the flu, wash your hands often. And get a flu vaccine every year.
• Get the pneumococcal vaccine (to prevent pneumonia, meningitis, and other infections). If you have had one before, ask your doctor if you need another dose.
• Clean any wounds or scrapes.
• Do not smoke or use other tobacco products. When you quit smoking, you are less likely to get a cold, influenza (the flu), bronchitis, and pneumonia. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Septicemia and Bacteremia in Dogs

Bacterial Infection of the Blood (Sepsis) in Dogs

Bacteremia and septicemia occur when the persistent presence of bacterial organisms in a dog’s bloodstream becomes systemic, meaning that it has spread throughout the body. This is also referred to as blood poisoning, and septic fever. This condition becomes very dangerous when it leads to abnormally low blood pressure and high body temperature, and can be fatal if left untreated. In severe cases, when the condition has progressed to septic shock, treatment alone will not be enough to save an animal.

Symptoms and Types

There are several signs and symptoms of both septicemia (blood infection) and bacteremia in dogs. Remember that septicemia and bacteremia are not the same thing, although they are similar, and are often used interchangeably.

• Sepsis and bacteremia in dogs may develop slowly or suddenly
• Signs and symptoms may vary, or they may involve many different organ systems, including the cardiovascular system
• Symptoms are often confused with the signs and symptoms of many other immune-regulated diseases
• Clinical symptoms are often more severe when the organisms involved are gram-negative organisms. These types of organisms are more likely to cause diseases in the dog
• Typically, dogs will develop signs and symptoms of the disease in the gastrointestinal tract first
• Initial physical signs and symptoms typically include chills, fever, and lethargy
• Depression symptoms are common in dogs
• Tachycardia (rapid heart beat) and heart murmur are common

Causes

The causes for sepsis and bacteremia in dogs typically include exposure to gram negative organisms, or those organisms that cause diseases in their hosts, including the E. Coli bacteria. Risk factors for the disease may include an existing health condition, such as diabetes mellitus, or liver and kidney failure. Dogs that have weakened immune systems, or those that have skin infections and urinary tract infections are also at risk. Any condition that lowers the immune system places a dog at risk for contraction of a bacterial disease.

Diagnosis

A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and a urinalysis. Before diagnosing your dog, your doctor will want to rule out other possible causes for illness. Diseases that cause similar symptoms may include immune-mediated diseases. Examples of these types of diseases can include autoimmune diseases like thyroidits or lupus.

Radiographic imaging may discover abscesses on the internal organs.

Treatment

Successful treatment involves diagnosing the problem quickly enough for the affected dog to receive prompt treatment and aggressive intervention. It is important that the problem be addressed as soon as possible due to the possible severity of the condition. Low blood pressure is the most common complication of the disease. Other complications associated with this disease include low blood sugar and electrolyte imbalances. Infections are also common. Dogs may be more prone to developing an abscess from an infected wound under the skin.

Nutritional support can dramatically improve the health of dogs with sepsis and bacteremia. If your dog is not able to eat by itself, it will be necessary to place an intravenous feeding tube until your dog is stable and capable of eating again. Medications that may help improve the outcome include antibiotics, antimicrobials, and specialized antibiotics that work specifically on this type of infection (as opposed to routine antibiotics).

Living and Management

It is possible for complications to occur, and a high rate of mortality is associated with this condition. The primary concerns associated with septicemia and bacteremia are electrolyte imbalances, low blood pressure, and shock. It is extremely critical to seek prompt medical attention for your dog if you suspect any type of infection is imminent or present.

90,000 Determination of procalcitonin levels to reduce mortality in adults with sepsis

Review question

Is procalcitonin measurement effective in reducing mortality and duration of antimicrobial therapy in adults with sepsis?

Relevance

Sepsis is understood as a confirmed or suspected infection associated with systemic inflammatory response syndrome (SIRS). This condition can lead to acute organ failure known as “severe sepsis”; or persistent hypotension that persists even after adequate fluid replacement is known as “septic shock”.Procalcitonin (PCT) is a biological indicator in the blood that has been shown to increase with blood infection. We wanted to assess whether the determination of the PCT level can lead to a decrease in mortality and the duration of antimicrobial therapy in adults with an infection in the blood. To do this, we compared PCT with no definition, with standard care (routine clinical judgment only), and with other blood chemical indicators. Currently, among other chemical indicators, there are: C-reactive protein (CRP), interleukins and neopterin.

Research characteristics

Evidence is current to July 2015. However, we resumed our search in October 2016 and added three studies of interest when we updated this review. We included 10 studies in this version of the review. These studies were carried out in Australia, Brazil, China, Czech Republic, France, Germany, Indonesia and Switzerland. Researchers evaluated participants in academic and non-academic surgical, general and trauma intensive care units (ICUs), and emergency departments.All studies analyzed adults with confirmed or suspected blood infection. Typically, comparisons were made with standard care, but one trial compared with CRP-controlled antibiotic therapy. The authors of 6 trials either worked as consultants or received funds from companies that perform procalcitonin testing.

Highlights

Results showed no significant difference in mortality over the long term (124/573; 21.6% versus 152/583; 26.1%), within 28 days (37/160; 23.1% versus 39/156; 25%), upon discharge from ICU (28/247; 11.3% versus 25/259; 9.6%) or upon discharge from hospital (82 / 398; 20.6% versus 81/407; 19.9%) for the PKT and non-PKT groups, respectively. The researchers also found no differences in mechanical ventilation, clinical severity, reinfection (re-infection), or duration of antimicrobial therapy. None of the studies reported on participants who had switched from broad spectrum antibiotic therapy to narrower spectrum antibiotic therapy.

Quality of evidence

We estimate that the quality of the available evidence ranged from very low to moderate due to the lack of methods for avoiding errors during the study or the lack of information about these methods, as well as the probably insufficient number of studies and patients to evaluate the outcomes. In addition, the authors of most of the studies worked as consultants and / or received funds from companies that perform procalcitonin testing.

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90,000 Blood test for infections – Federal State Budgetary Institution “NMITs TPM” of the Ministry of Health of Russia

As practice shows, the most dangerous and serious diseases have an infectious origin. Detection of infection at an early stage allows you to prevent the transition of the disease to the chronic phase as a result of the appointment of the patient with the most effective course of treatment. A blood test for infections will help to draw conclusions as soon as possible regarding the presence of viruses in the patient’s body. Based on the data obtained, the attending physician will be able to select the necessary drugs to combat a particular disease.

Our clinic carries out a full range of laboratory studies related to blood tests.Our own technological base (the center is equipped with imported equipment) allows us to guarantee accurate results. Blood sampling for laboratory tests is painless, in accordance with all the norms and requirements established by the current regulations. Our specialists conduct a blood test for syphilis, detect such dangerous diseases as hepatitis, HIV, syphilis (gonorrhea).

Blood Research Laboratory works in the following areas:

• Immunological blood test. A set of measures to determine local and systemic changes in the activity of the immune system. The method is used when a patient is diagnosed with an immune deficiency state or suspected of it. The data obtained as a result of such studies allow predicting the development of a significant number of diseases.
• Serological blood test. The method is based on the analysis of antibodies and antigens present in the patient’s blood. The work is carried out not with the pathogen itself, but with the products that appear in the body as a result of the activity of certain harmful viruses.It is thanks to this methodology that blood tests are carried out for hepatitis, intestinal infections, pneumonia.
• Molecular genetic studies by PCR. The method is based on the polymerase chain reaction, thanks to which it is possible to obtain information regarding the genetic material of the virus in the body. The study by the PCR method of the genetic mass occurs in three stages: blood sampling, amplification (impact on the material), and detection of the virus. It should be noted that this method is recognized as one of the most reliable and accurate.

Please note that the life and health of the patient directly depends on the test results. It is necessary to trust the conduct of such a procedure only to highly qualified, accredited specialists.

In our clinic, you can always undergo a genetic analysis of PCR blood, as well as a set of other procedures that allow you to perform a blood test with high accuracy. The staff pay attention to each patient, making the stay at the center as comfortable as possible.

By entrusting the care of yourself and your loved ones to professionals, you make the right decision!

This page is for informational purposes only. Find out the exact list of services provided and the specifics of the procedures by phone.

Procalcitonin in the diagnosis and treatment of bacterial infections

Relevance. Despite the successful use of diagnostic biomarkers in various fields of medicine (for example, D-Dimer in pulmonary embolism, natriuretic peptide in acute heart failure, Troponin I in myocardial infarction), accurate and timely diagnosis of bacterial infections remains a problem.Until recently, there were no reliable clinical or microbiological parameters that can be used to diagnose bacterial infections and rule out infections. The main disadvantages of many modern microbiological diagnostic methods are time lags (for example, culture methods), suboptimal sensitivity (for example, blood cultures), and low specificity due to contamination (for example, sputum culture), while others are not amenable to routine diagnostics due to for their invasive nature (eg, lung biopsy).

Previous studies have examined the use of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and C-Reactive protein for diagnosing infections, predicting bacteremia, disease severity and mortality. A common obstacle to the wide clinical use of these biochemical markers is their non-specificity and the lack of correlation between the severity of the disease and the concentration of the marker in the body.

Quite by chance it was discovered that with a bacterial infection, the concentration of PCT in the blood increases.In the late 1980s, it was found that in thyroid cancer and some forms of lung cancer, along with an increase in Calcitonin (CT), also an increase in the level of Procalcitonin (PCT). In 1992, the continuous presence of CT and PCT in the blood of burn patients was demonstrated. Moreover, in some patients with septicemia, high PCT levels were found, while CT values ​​remained normal.

Characteristic. Procalcitonin is a polypeptide, a precursor of the hormone Calcitonin, that does not exhibit hormonal activity and is produced during inflammation.PCT does not affect calcium metabolism. Normally, all PCT is converted to calcitonin in thyroid C-cells in response to hormonal stimulants and practically does not enter the bloodstream. It has been experimentally proven that an increase in the PCT level in blood plasma occurs only under the action of bacterial endotoxins and strongly correlates with the severity of a bacterial infection. Due to the rapid immune response, the PCT level rises within 6-12 hours after infection, and in the case when the infection is controlled by the immune system or antibiotic therapy, the amount of PCT circulating in the blood daily decreases by half.

In general, the concentration of PCT circulating in the blood is extremely low. In healthy donors, it is determined at the level of 0.01 ng / ml. In viral infections and during inflammation, the PCT level increases slightly, rarely reaching 1 ng / ml. However, in severe bacterial infections, it can grow from 20 to 200 ng / ml.

Research. Based on these data, PCT was proposed as a marker candidate for the diagnosis of bacterial infections and as a criterion for assessing the effectiveness of antibiotics.Studies conducted to compare CRP and PCT values ​​and their correlation in bacteremia, systemic inflammatory response syndrome (SIRS), sepsis and septic shock conducted in emergency departments [1] showed the following results:

The CRP level increased during bacteremia, but did not make it possible to differentiate the type of infection (the level of CRP increases with any inflammation, regardless of etiology), while the PCT level remained low with non-bacterial infection, and with bacteremia and septic shock, its values ​​were highly informative and amounted to more than 2.5 ng / ml.

Observations and studies were carried out through randomized control trials in Switzerland, Germany, France, Denmark and China until 2011. The data obtained showed that the determination of the PCT level significantly helps in the diagnosis and advisability of prescribing antibiotic therapy for bacterial infection, primary blood infection, bronchitis, exacerbation of chronic obstructive pulmonary disease, pneumonia (including ventilator-associated pneumonia), postoperative infections, severe sepsis / shock and upper respiratory tract infections [2].

Gradation. Based on the studies carried out, the PCT level was differentiated with recommendations for the use of antibiotics. So, depending on the history, antibiotic treatment should be started at a PCT concentration of 0.1-0.5 ng / ml; this may indicate local inflammation or local infection, and in such cases it is recommended to measure the PCT level again after 6-12 hours. PCT concentration values ​​of more than 0.5 ng / ml are defined as pathological, with a suspicion of septic syndrome.In the PCT range from 0.5 to 2 ng / ml, the diagnosis of sepsis cannot be made with certainty, therefore it is recommended to repeat the PCT measurement after 6-24 hours to make an accurate diagnosis. If the PCT level remains unchanged or increased for more than 4 days, an assessment of the ongoing therapy for sepsis should be carried out. A PCT level above 2 ng / ml is highly likely to indicate an infectious process with systemic inflammation, and a concentration of more than 10 ng / ml is observed exclusively in patients with severe sepsis or septic shock (daily monitoring of the PCT level remains important).It is important to note that, like any other diagnostic indicator, PCT should be used in a comprehensive manner in the context of other clinical parameters.

Diagnostic methods. In daily laboratory diagnostics, enzyme immunoassay is most often used. It is a quantitative method that meets thresholds and is relatively easy to perform. The company “Diameb” can offer you ELISA kits for the determination of Procalcitonin from both domestic and foreign manufacturers.

In the case of severely ill patients, when urgent results are required, the best solution is the use of immunochemiluminescent analysis (CLIA), which makes it possible to obtain the result in 17 minutes (on automatic IHLA analyzers of the Maglumi series). The incubation time in this method is only 15 minutes, and the reading takes only 3 seconds, with a sensitivity of 0.01 ng / ml PCT. For patients with suspected septic shock, for example, this factor can reduce mortality and accelerate recovery.

And not the last in diagnostics are express tests, which are most relevant for medical institutions of primary and secondary levels. The threshold value of rapid tests offered by Diameb is 1 ng / ml PCT, which, in combination with other diagnostic indicators, may be an indication for the prompt appointment of adequate antibiotic therapy.

Conclusion. So, given that misdiagnosis and the appointment of an inadequate course of antibiotics causes resistance of microorganisms to their action, dysbiosis and side reactions, increases the cost of treatment, as well as the fact that some infectious diseases are asymptomatic or with a slight deviation from the norm – the use of PCT in as a criterion for making decisions about initiating and / or stopping antibiotic therapy has a tremendous impact on the success of treatment.

1. Y-L. Chan, C-P. Tseng, P-K. Tsay, S-S. Chang, T-F. Chiu, J-C. Chen: Procalcitonin as a marker of bacterial infection in the emergency department: an observational study.