Post-Sepsis Syndrome Overview

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Post-sepsis syndrome is a collection of long-term physical and psychological symptoms that develop in roughly 50% of sepsis survivors. Sepsis is an extreme reaction carried out by the body when an infection is present. It is a medical emergency because it is life-threatening.

Symptoms of post-sepsis syndrome can develop within 90 days of recovering from sepsis and include fatigue, joint pain, and panic attacks. The symptoms can last anywhere from six to 18 months.

This article discusses the frequent and rare symptoms associated with post-sepsis syndrome and the complications that may develop because of it.

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Frequent Symptoms

Post-sepsis syndrome affects many bodily systems. They include:

  • Cardiovascular
  • Neurological
  • Psychological
  • Immune health
  • Metabolic
  • Neuromuscular
  • Renal
  • Pulmonary

Because sepsis infection can cause the entire body to undergo negative changes, countless symptoms may arise when a person develops post-sepsis syndrome. Symptoms can be both physical and psychological.

Some of the most common physical symptoms include:

  • Sleep disturbances that make it hard to either fall asleep or stay asleep throughout the night
  • Fatigue
  • Lethargy
  • Difficulty breathing and shortness of breath
  • Muscle or joint pain so severe it's debilitating
  • Swelling in the limbs
  • Repeated infections
  • Loss of appetite
  • A reduction in organ function that affects the kidneys, liver, and heart
  • Hair loss
  • Skin rash
  • Imbalance of gut bacteria
  • Widespread inflammation

The psychological symptoms most associated with post-sepsis syndrome include:

These symptoms can make coping with post-sepsis syndrome nearly impossible.

Cause of Post-Sepsis Syndrome

The damage to various organs and bodily systems is likely to blame for the widespread and debilitating post-sepsis symptoms.

Rare Symptoms

Though post-sepsis syndrome isn’t always life-threatening, it can cause serious health complications because of the way it affects various bodily systems.

The more severe and rare complications and symptoms of post-sepsis syndrome include:

Rare Complications and Symptoms of Post-Sepsis Syndrome
Complication  Symptoms
Heart failure Fatigue, shortness of breath, weakness, swelling in the limbs, irregular heartbeat, persistent cough, abdominal swelling
Myocardial infarction Chest pain that travels from the left arm up toward the neck, shortness of breath, increased sweating, nausea, vomiting, abnormal heartbeats, anxiety, fatigue, weakness
Stroke Sudden weakness or numbness on one side of the body affecting the face, arms, and legs, confusion, trouble speaking or understanding speech, dizziness, loss of balance, difficulty seeing out of one or both eyes
Cognitive decline Increased risk for dementia, epilepsy, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS)
Delirium Hallucinations, agitation, feeling combative or restless, making sounds or moaning for no known reason, being unnaturally quiet or withdrawn, lethargy
Immunosuppression Frequent infections, digestive issues such as nausea, vomiting, cramping, or diarrhea, the development of blood disorders
Uremia Nausea, vomiting, fatigue, weight loss, muscle cramps, itchy skin, mental state changes
Hyperglycemia Nausea, vomiting, shortness of breath, dry mouth, confusion, weakness, coma
Nerve damage Muscle weakness in the arms or legs, severe pain in the arms, legs, feet, or joints, impaired mobility
Dysphagia Difficulty swallowing, being unable to swallow at all, coughing or choking when trying to eat or drink
Heterotopic ossification The formation of new bone in soft tissues and muscles, leading to decreased range of motion, swollen joints, warm joints, fever, pain in the muscles and joints 
Kidney failure Swelling in the legs, ankles, or feet caused by fluid retention, shortness of breath, fatigue, a decreased need to urinate or less urine output, confusion, nausea, weakness, irregular heartbeat
Lung disease Trouble breathing or shortness of breath, feeling as though you cannot get enough air into your lungs, a persistent cough that may be accompanied by blood or mucus, pain when breathing
Acute respiratory distress syndrome Shortness of breath, rapid breathing, hearing a clicking, bubbling, or rattling sound in your lungs when you breathe

Post-Sepsis Syndrome and Death

The death rate of post-sepsis syndrome isn’t well known. That said, there is a high mortality rate in people who had sepsis and recovered. The rate of sepsis deaths roughly two years after hospitalization ranges from 22% to 70%.

Complications of Preexisting Conditions

There is a connection between preexisting conditions and the risk of developing post-sepsis. The severity of post-sepsis syndrome may also correlate with preexisting health disorders.

Some conditions and health issues that can increase the risk of developing post-sepsis syndrome and worsened outcomes include:

  • Damage to the intestinal barrier
  • Gut bacteria imbalances (gut dysbiosis)
  • Lack of energy in the cells (mitochondrial damage)
  • Chronic cardiovascular disease
  • Diabetes
  • Chronic lung disease
  • Chronic kidney disease
  • Inflammatory diseases
  • Obesity
  • High cholesterol
  • Low levels of good cholesterol

Reducing the Risk

Because a preexisting condition can worsen post-sepsis syndrome, it is possible to lower your risk with lifestyle changes. Infection prevention techniques include:

  • Cleaning all scrapes and cuts
  • Washing your hands and bathing regularly
  • Watching for signs of infection to get treatment quickly
  • Getting vaccinated

When to See a Healthcare Provider

If you start to experience any symptoms of post-sepsis syndrome following recovery from sepsis, contact your healthcare provider.

Though the syndrome isn’t always dangerous, it can lead to severe and life-threatening health complications. You will want to ensure that you seek the medical help you need to monitor and treat it effectively.

Treatment for Post Sepsis Syndrome

There are various treatments available for post-sepsis syndrome. The therapy you receive will depend entirely on the symptoms you are experiencing and how the syndrome affects your body. Some possible treatments include:

Summary

Post-sepsis syndrome develops following sepsis. The syndrome has many different symptoms that affect you both physically and psychologically. Common symptoms include cognitive decline, fatigue, shortness of breath, weakness, new onset of anxiety or depression, post-traumatic stress disorder, and sleep disturbances.

In some cases of post-sepsis syndrome, people may develop more severe health issues, including organ damage to the heart, lungs, and kidneys. Because some of the syndrome's complications can be life-threatening, it's vital to contact your healthcare provider if you experience any of the symptoms of post-sepsis syndrome.

A Word From Verywell

Having sepsis can be a traumatic experience because it is severe and life-threatening. The risk of developing post-sepsis syndrome only makes things worse because if you do recover, you may still have to cope with other health complications and debilitating symptoms.

The best thing you can do to avoid post-sepsis syndrome is everything you can to protect yourself against infections that can lead to sepsis. It’s not always easy, but you can reduce your risk with good hygiene practices and appropriate wound care.

Frequently Asked Questions

  • How long does post-sepsis syndrome last?

    The symptoms of post-sepsis syndrome can begin to develop within 90 days of recovery. After they do, they can last anywhere from six to 18 months. It is hard to determine how long you will have to cope with the syndrome if you develop it because it’s difficult to predict.

  • Does post-sepsis syndrome shorten your lifespan?

    Sepsis has a high mortality rate of roughly 50%. If a person happens to be in the other 50% that survives, they could develop post-sepsis syndrome. Though not all people die from post-sepsis syndrome, the mortality rate is also high and can range from 22% to 70%.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sepsis Alliance. What is post-sepsis syndrome?

  2. van der Slikke EC, An AY, Hancock REW, Bouma HR. Exploring the pathophysiology of post-sepsis syndrome to identify therapeutic opportunities. EBioMedicine. 2020 Nov;61:103044. doi:10.1016/j.ebiom.2020.103044

  3. Mostel Z, Perl A, Marck M, et al. Post-sepsis syndrome - an evolving entity that afflicts survivors of sepsis. Mol Med. 2019 Dec 31;26(1):6. doi:10.1186/s10020-019-0132-z

  4. Gritte RB, Souza-Siqueira T, Curi R, Machado MCC, Soriano FG. Why Septic Patients Remain Sick After Hospital Discharge? Front Immunol. 2021 Feb 15;11:605666. doi:10.3389/fimmu.2020.605666

By Angelica Bottaro
Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space.