Introduction
Sepsis is a very serious ,life threatening medical condition which requires special attention and treatment by health professionals. Sepsis is body extreme response to an infection. In most cases , sepsis may start before a patient goes to the hospital.
Bacterial Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without treatment on time , sepsis can rapidly lead to tissue damage, drop in blood pressure, multiple organ failure, and eventually death. Therefore as soon as you discover that anyone you know has Sepsis ,take it very very seriously even when the symptoms are less.
If Sepsis isn’t recognized and treated quickly, it can progress to severe sepsis and then to septic shock. 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.
Major issue with Sepsis is that its symptoms are so vague and like many other known disease that even the doctors have difficult time diagnosing it .
Who can get Sepsis?
>Most people who develop sepsis have at least one underlying medical condition, such as chronic lung disease, Kidney disease, liver disease such as cirrhosis or a weakened immune system. Nearly a quarter to a third of people with sepsis had a healthcare visit in the week before they were hospitalized.
It means that most of them may get infected by visiting the hospital ,people with weakened immune system contract bacterial infection in ICUs, wards through Urine catheters, IV cannulas etc and these infections spread from physical contact with infected person to uninfected Person.
> Burns, Major surgery, Prolonged hospitalization, Hemodialysis etc are also risk factors that can cause Sepsis.
Symptoms of Sepsis
>Lethargy that won’t go away , which doesn’t resolve in spite of taking correct diet. Patient may not be able to stand up, feel dizziness.
>If you have chest drain placed due to fluid buildup in your lungs then fluid volume in the drain will be very high (1.0-2.5 ltrs in 24 hrs) and doctors often confuse this situation with underlying kidney, liver or heart disease as all of them cause fluid retention in the body.
>Abnormal pain in the body.
>Red spots and skin rashes on skin.
>Pain while Urinating.
>Mental confusion and disorientation. Patient fail to comply with simple instructions ,unable to convey their thoughts clearly.
How Sepsis is Diagnosed?
It is diagnosed by conducting Procalcitonin Test ,this test measures the level of procalcitonin in the blood. A high level of procalcitonin in the blood may be a sign of a serious infection or sepsis. When PCT level increases to high levels it is called Septic Shock.
Healthy subjects/non-infected patient: < 0.5 ng/ml
Borderline risk : 0.5-2.0 ng/ml
High risk of severe sepsis/Septic Shock: > 2.0 ng/ml
The earliest signs of inflammation are diagnosed by the following:
- Fever (temperature higher than 38 C or hypothermia (temperature less than 36 C)
- Tachycardia (heart rate more than 90 beats per minute),
- Tachypnea (respiratory rate more than 20 breaths per minute)
- Leukocytosis (WBC greater than 12,000/cu mm) / leukopenia (white blood cells (WBC) less than 4,000/cu mm) with or without bandemia (more than 10%).
Treatment after Sepsis has been diagnosed:
Doctors conduct Blood and Urine culture tests and prescribe antibiotics according to the test report. Patient is given fluids and condition is strictly monitored. Some strain of bacteria which has caused Sepsis may be antibiotic resistant ,then a combination of antibiotics may be prescribed or new antibiotics may also be prescribed. If Blood pressure is dropping, medicines which raises the blood pressure called positive inotropes is given.
Septic Shock
Septic shock is last stage of Sepsis, it means Sepsis has increased to dangerously high level, its a life-threatening condition that happens when blood pressure drops to a dangerously low level after an infection , it means that blood isn’t reaching vital organs, such as the brain and liver. Septic Shock carries a high mortality rate.
One of the bacteria that causes sepsis is Klebsiella pneumoniae ,some strain of it is carbapenem (last resort antibiotic) resistant and thus it’s infection can be life threatening. You may read more about antibiotic resistant bacteria here.
Click here to read WHO information on sepsis .
Frequently Asked Questions (FAQs) on Sepsis and Septic Shock:
- What is sepsis?
Sepsis is a severe medical condition that occurs when the body’s response to an infection leads to systemic inflammation, which can result in organ dysfunction and failure. - What causes sepsis?
Sepsis is typically caused by bacterial, viral, or fungal infections. Common sources of infection include pneumonia, urinary tract infections, and wounds. - What are the symptoms of sepsis?
Symptoms of sepsis can include fever, high heart rate, rapid breathing, confusion, low blood pressure, and signs of organ dysfunction. It can progress rapidly and become life-threatening. - What is septic shock?
Septic shock is the most severe stage of sepsis and is characterized by profound circulatory and cellular abnormalities, resulting in dangerously low blood pressure, inadequate tissue perfusion, and organ failure. - What are the common risk factors for developing sepsis?
Risk factors include age (the very young and elderly are at higher risk), a weakened immune system, chronic medical conditions, recent surgeries, and invasive medical procedures. - How is sepsis diagnosed?
Sepsis is diagnosed based on clinical signs, laboratory tests (PCT test), and imaging. Key indicators include a high or low white blood cell count, elevated C-reactive protein levels, and signs of organ dysfunction. - What is the treatment for sepsis and septic shock?
Treatment typically involves administering antibiotics to treat the underlying infection, intravenous fluids to maintain blood pressure, and medications to support organ function. In severe cases, mechanical ventilation or kidney dialysis may be necessary. - Can sepsis be prevented?
While sepsis cannot always be prevented, proper wound care, infection control practices, immunizations, and early treatment of infections can reduce the risk of developing sepsis. - Is sepsis contagious?
Sepsis itself is not contagious. It is a response to an infection, and the causative infection may or may not be contagious, depending on the pathogen. - Is sepsis a common condition?
Sepsis is a relatively common and potentially life-threatening condition. The incidence of sepsis has been increasing, partly due to an aging population and antibiotic-resistant infections. - Can sepsis be fatal?
Yes, sepsis can be fatal if not treated promptly and appropriately. It is a leading cause of death worldwide, especially in intensive care unit (ICU) patients. - Is there ongoing research on sepsis and septic shock?
Yes, there is ongoing research to better understand sepsis, its causes, treatment strategies, and early detection methods. Researchers are working to improve outcomes and reduce mortality. - What are the long-term effects of surviving sepsis?
Survivors of sepsis may experience physical, psychological, and cognitive impairments. These long-term effects are collectively known as “post-sepsis syndrome” and may require rehabilitation and support.