What Is Septic Shock?

A severe, life-threatening response to an infection.

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Septic shock is the most severe level of sepsis, a life-threatening medical emergency that occurs when the immune system has an extreme response to an existing infection. Immune chemicals are released into the bloodstream, the body attacks its own tissues, and blood pressure drops dangerously low. Septic shock is a systemic problem that requires urgent medical care.

Most infections that lead to sepsis and septic shock are caused by bacteria. Septic shock often requires large amounts of IV fluid, medication to support blood pressure, and multiple antibiotics.

close-up of surgeons hands making an incision in a patient
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Septic Shock

The most severe form of sepsis, a life-threatening response of the immune system to an infection, that can lead to organ failure and death.

Causes

Infections that lead to sepsis and septic shock most commonly begin in the lungs (pneumonia), urinary tract (urinary tract infection), skin (bacterial infection in cut or wound), or gastrointestinal tract. However, sepsis can start with almost any type of infection ranging from minor (abscessed tooth, athlete's foot) to serious (meningitis).

Some patients who develop septic shock were completely unaware of their initial infection. As sepsis worsens into septic shock, blood pressure drops dangerously low and blood flow to organs is reduced.

Septic shock most commonly occurs as a response to a bacterial infection, but it can also be a complication of viral infections, such as the flu or COVID-19, or fungal infections. You can't spread sepsis to someone else, but you can spread infections that then lead to sepsis and septic shock.

With a typical infection, the body responds to the threat of infection, keeping the infection at the site of origin.

When the body is unable to contain the infection in the original site, it can spread in the blood, triggering sepsis. When bacteria from one area of the body enters the bloodstream, it is known as known as bacteremia or septicemia, which may progress to septic shock.

Septic Shock After Surgery

Sepsis and septic shock are more common after surgery for several reasons. First, urinary tract infections are more common after surgery, and these infections can lead to sepsis. Second, an incision is an opening into the body through which infection can begin. Surgery takes a toll on the body and weakens the immune system, even if the procedure is a minor one, which can make infections more likely.

It is important to remember that not all infections will become sepsis, and even fewer will become septic shock. Many infections are so minor that we may not even realize we have them, and the vast majority of infections that require treatment respond very well to antibiotics. After surgery, it is imperative to be mindful of the signs and symptoms of infection.

Unfortunately, while rare, septic shock can attack the young and the healthy. It is not uncommon for someone to seem completely well and normal one day, and be incredibly sick with septic shock 48 hours later.

Signs of Septic Shock

If you have any signs or symptoms of sepsis or septic shock, especially if you have a known infection, seek immediate medical attention to increase your chances of survival.

Symptoms of sepsis and septic shock can include:

  • Confusion or disorientation
  • Intense pain or discomfort
  • Fever, shivering, or feeling very cold
  • Shortness of breath
  • Clammy or sweaty skin
  • Fast heart rate

When sepsis progresses to septic shock, blood pressure drops dangerously low and can lead to organ failure.

Diagnosis

There are physical changes that a physician can check for in order to diagnose septic shock. This can include:

  • Fever (high body temperature) or hypothermia (low body temperature)
  • Low blood pressure
  • High heart rate
  • Difficulty breathing

In addition, your doctor may run blood and urine tests to check for signs of infection, type of infection, and impairments in organ function (kidneys, liver).

Your doctor may also order imaging tests, such as X-rays or computed tomography (CT scans), especially if the source of infection is unclear.

Treatment

Prompt medical care is crucial for septic shock and treatment in a hospital intensive care unit (ICU) is often required.

Sepsis and septic shock can be treated, in most cases, with antibiotics if it's the result of a bacterial infection. If it is due to other types of infections, you may be given antifungals, antivirals, or other targeted treatments based on the type of infection.

You will be given IV fluids to help keep blood pressure from dropping and you may be given vasopressor medications to help raise blood pressure. If breathing complications occur, a ventilator, also known as a respirator or breathing machine, may be needed.

Patients who have septic shock are typically treated with around-the-clock care in an ICU. The risk of death is significant if sepsis leads to septic shock, with approximately 40% of septic shock patients dying, even with treatment.

Surgeries may also be recommended to remove damaged tissue.

Risk Factors

An infection is a risk factor for septic shock and can occur to anyone and due to any type of infection. However, there some factors that can increase your risk, including:

  • Adults ages 65 or older
  • Children under age 1
  • Having a weakened immune system
  • Surviving sepsis previously

Having a chronic medical condition is also risk factor and can include:

A Word From Verywell

Septic shock can be very scary, but by knowing the signs and symptoms, you can be prepared to seek urgent medical care and get prompt treatments that can be life saving.

If you or a loved one is a survivor of septic shock, you may want to join support groups or connect and share your story with others who have battled sepsis and/or any ongoing health issues related to septic shock. Resources are available to help you cope in your recovery through the nationwide Sepsis Alliance.

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Article 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. Centers for Disease Control and Prevention. What is sepsis? Updated January 27, 2021.

  2. Centers for Disease Control and Prevention. How is sepsis diagnosed and treated? Updated August 18, 2020.

  3. Cleveland Clinic. Sepsis. Updated September 17, 2019.

  4. Daviaud F, Grimaldi D, Dechartres A, et al. Timing and causes of death in septic shockAnn Intensive Care. 2015;5(1):16. doi:10.1186/s13613-015-0058-8

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