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sepsis

Definition
Sepsis is a severe infection in the body and bloodstream that can lead to shock, a reaction caused by lack of blood flow in the body.

What is going on in the body?
Sepsis can occur when a person has a severe infection. The infection may start in any part of the body, but usually starts with pneumonia (new-moan-ya), a serious inflammation in the lungs, or a urinary infection. Sepsis can also occur after an abdominal infection such as appendicitis (ah-pend-i-site-is). As the infection worsens, bacteria may enter the bloodstream. When this happens, toxins produced by the bacteria can affect the blood vessels. This causes severe low blood pressure. This is known as septic shock, and is a medical emergency. If not treated, septic shock will lead to death.

What are the signs and symptoms of the infection?
Symptoms of septic shock include:
  • very low blood pressure
  • a fast heart rate
  • a weak pulse
  • fever
  • flushing
  • sweating
  • changes in mental status


What are the causes and risks of the infection?
Septic shock can occur with any severe infection. It is more common with severe abdominal infections or lung infections such as pneumonia. People with an immune system that is not working are especially prone to septic shock. This includes people with AIDS or those getting cancer treatment. The very young and very old are also prone to sepsis.

What can be done to prevent the infection?
Preventing or treating the initial infection can prevent sepsis. Not all infections lead to sepsis.

How is the infection diagnosed?
The diagnosis is based on a physical examination and a history of severe infection. Sepsis is also suspected when a person has low blood pressure and a fast heart rate. Blood cultures are done. These will often show growth of bacteria. This confirms the diagnosis.

What are the long-term effects of the infection?
People with sepsis will either get rid of underlying infection or die. There are few long-term effects related to sepsis. In some cases, the brain or kidneys may be permanently damaged.

What are the risks to others?
Although sepsis is caused by infections, these infections are usually not contagious.

What are the treatments for the infection?
Sepsis is treated with antibiotics, fluids injected directly into the body, and medications to restore normal blood pressure. The person is usually treated in the intensive care unit of a hospital. Certain heart or lung monitors may be placed in the person to measure blood pressure and other vital signs. Some people may need a ventilator (a breathing machine) to help them breathe. Sepsis will usually improve as the infection heals. In some cases surgery, is needed to remove or drain an abscess (ab-sess) or other tissue.

What are the side effects of the treatments?
Side effects depend on the medication taken. People who have surgery are at high risk.

What happens after treatment for the infection?
The person is monitored to make sure blood pressure returns to normal and the sepsis resolves.

How is the infection monitored?
The person will be monitored with physical examinations and blood tests. Cultures will be taken of blood, urine, or other fluids to check for continuing infection.

Author: Bill Harrison, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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