What Is Sepsis?

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Sepsis is a very serious, potentially life-threatening condition that occurs when a localized infection, like a urinary tract infection (UTI) or surgical wound infection, moves into the bloodstream. As the infection spreads, the body launches a massive inflammatory response, causing symptoms like a fever and a fast heart and breathing rate. If untreated, sepsis may progress into septic shock, which causes low blood pressure and subsequent multi-organ failure.

Treatment of sepsis and septic shock requires treatment of the underlying infection, as well as interventions to alleviate the effects and to prevent organ damage.

symptoms of sepsis
Verywell / Gary Ferster

Sepsis Symptoms

Symptoms and signs of sepsis include the following:

  • Fever, followed by hypothermia (low body temperature)
  • Sweating
  • Tachycardia (rapid heart rate)
  • Tachypnea (rapid breathing)

As sepsis worsens, septic shock may develop, which indicates that the organs in your body are not being sufficiently perfused—that is, they're not getting enough blood and oxygen.

Potential symptoms and signs of septic shock include:

  • Low blood pressure
  • Warm skin followed later by peripheral cyanosis (cool, pale hands and feet)
  • Confusion or decreased alertness
  • Low urine output
  • Edema (swelling due to fluid build-up)
  • Liver, heart, and kidney dysfunction
  • Shortness of breath
  • Bleeding problems

If you experience any symptoms of sepsis or septic shock, seek immediate medical treatment.

Causes

Sepsis always begins with an infection. There are several factors that increase a person's risk for sepsis and septic shock, although healthy people with no risk factors can develop sepsis as well.

Some key risk factors for sepsis and septic shock include:

  • Having a postoperative infection, which is an infection after surgery
  • A severe burn affecting a large area of the body
  • Treatment with chemotherapy, corticosteroids, or other immune-suppressing drugs
  • Presence of invasive devices, like a urinary catheter, indwelling line, or drainage or feeding tube
  • Use of intravenous drugs
  • Having certain underlying issues like diabetes, cirrhosis, sickle cell disease, or a weakened immune system

Women who are pregnant or who have given birth or experienced a miscarriage within the prior six weeks, newborns and infants under the age of 1, and the elderly (above the age of 75) are also at an increased risk for developing sepsis and septic shock.

How Sepsis Develops

Sepsis and septic shock are complex processes. Sepsis occurs when the body releases inflammatory proteins and enzymes in response to an infection (usually bacterial). Rarely, a virus, fungus, or parasite is the cause.

The inflammatory substances released by the body cause many different effects:

  • Blood clots may form, which can block blood flow to tissues and organs in the body
  • The arteries dilate (widen), which causes hypotension (low blood pressure)
  • Fluctuations in blood pressure, heart rate, and respiration
  • Acidosis of the blood

These stresses are so overwhelming for the body that it becomes impossible to compensate without medical intervention. As the sepsis worsens, septic shock may develop. With this, the oxygen delivery to organs in the body becomes severely jeopardized to the point that organs, especially the liver, kidney, intestines, heart, and lungs, begin to fail.

Diagnosis

One of the difficulties in diagnosing sepsis quickly and accurately is that the symptoms are similar to those of other health conditions, such as food poisoning, the flu, or heart and lung problems. That said, sepsis is relatively rare compared with the common flu, so it often isn't considered until it worsens and the following physical exam findings develop:

  • Hypothermia
  • Rapid heart rate
  • Low blood pressure
  • Fast breathing rate

In addition to performing a physical exam, a healthcare provider will order several blood tests to help diagnose sepsis or septic shock. Examples of these blood tests include a complete blood count (CBC), electrolyte panel, creatinine, liver function test, and lactate level. Blood and urine cultures will also be ordered. In some cases, other body fluid cultures—for example, synovial fluid or cerebrospinal fluid—may be ordered as well.

Imaging tests may be ordered, such as a chest X-ray for possible pneumonia or a computed tomography (CT) scan to look for an infected fluid collection (abscess).

Treatment

People with sepsis and septic shock are treated in an intensive care unit (ICU) by a critical care team. Due to the severity of the inflammatory response, patients need close monitoring and are usually sedated and placed on a ventilator.

Overall, the main goals of sepsis/septic shock treatment are to:

  • Ensure good blood flow to the organs
  • Treat the underlying infection

Optimizing Organ Perfusion

In order to provide adequate blood flow to the organs, oxygen may be provided and a central line is usually placed in a vein in the neck or the groin to provide large volumes of fluid rapidly.

In addition to intravenous fluids, blood or medications that help raise the blood pressure (called vasopressors) are usually also administered in the central line.

If septic shock develops, certain organs may fail to the point that an intervention is needed, such as dialysis for kidney failure or a ventilator to help with breathing.

Treating the Infection

Even before the source of the infection is known, broad-spectrum antibiotics (and less commonly, antifungals) are usually given. Then, when the source of the infection is found, other interventions, such as draining an abscess or removing an infected catheter, may be needed.

Antibiotics may be adjusted based on the type of bacteria found in a culture.

Prevention

The only way to prevent sepsis is to prevent infections, such as post-operative infections. Infection prevention techniques, such as good wound care and frequent hand washing, can help with this.

Specifically, when it comes to washing your hands, the Centers for Disease Control and Prevention (CDC) recommends these five steps:

  • Wet your hands before applying soap.
  • Lather your hands thoroughly with the soap, including the backs of your hands, between your fingers, and underneath your nails.
  • Scrub your hands for at least 20 seconds—the duration it takes for you to sing the "Happy Birthday" song twice.
  • Rinse your hands thoroughly.
  • Dry your hands with a clean towel or air dry.

If soap and water are not available, using hand sanitizer is your next best option.

Other ways to prevent infection include staying up-to-date with your vaccines and promptly getting medical attention for any infection you have.

A Word From Verywell

A diagnosis of sepsis is extremely serious, as it can rapidly progress to septic shock, which may result in death. The best way to prevent sepsis is to prevent an infection in the first place, and it's important to remember that if you do develop an infection, you should seek prompt and appropriate care.

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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.
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