Sepsis
Septicemia; Sepsis syndrome; Systemic inflammatory response syndrome; SIRS; Septic shockSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
Causes
The symptoms of sepsis are not caused by the germs themselves. Instead, chemicals the body releases cause the response.
A bacterial infection anywhere in the body may set off the response that leads to sepsis. Common places where an infection might start include the:
- Bloodstream
- Bones (common in children)
- Bowel (usually seen with peritonitis)
Peritonitis
Peritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...
Read Article Now Book Mark Article - Kidneys (upper urinary tract infection, pyelonephritis or urosepsis)
Urinary tract infection
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
Read Article Now Book Mark Article - Lining of the brain (meningitis)
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Read Article Now Book Mark Article - Liver or gallbladder
- Lungs (bacterial pneumonia)
Bacterial pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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Cellulitis
Cellulitis is a common skin infection caused by bacteria. It affects the middle layer of the skin (dermis) and the tissues below. Sometimes, muscle...
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For people in or recently discharged from the hospital, common sites of infection include intravenous lines, surgical wounds, surgical drains, and sites of skin breakdown, known as bedsores or pressure ulcers.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Read Article Now Book Mark ArticlePressure ulcers
A pressure sore is an area of the skin that breaks down when something keeps rubbing or pressing against the skin.
Read Article Now Book Mark ArticleSepsis commonly affects infants or older adults.
Symptoms
In sepsis, blood pressure drops, resulting in shock. Major organs and body systems, including the kidneys, liver, lungs, and central nervous system may stop working properly because of poor blood flow.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
Read Article Now Book Mark ArticleA change in mental status and very fast breathing may be the earliest signs of sepsis.
Change in mental status
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark ArticleIn general, symptoms of sepsis can include:
- Chills
- Confusion or delirium
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark ArticleDelirium
Delirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness.
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Fever or low body temperature (hypothermia)
Hypothermia
Hypothermia is dangerously low body temperature, below 95°F (35°C).
Read Article Now Book Mark Article - Lightheadedness due to low blood pressure
- Rapid heartbeat
Rapid heartbeat
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
Read Article Now Book Mark Article - Skin rash or mottled skin
Skin rash
Rashes involve changes in the color, feeling or texture of your skin.
Read Article Now Book Mark ArticleMottled skin
Patchy skin color is areas where the skin color is irregular with lighter or darker areas. Mottling or mottled skin refers to blood vessel changes i...
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Exams and Tests
The health care provider will examine the person and ask about the person's medical history.
The infection is often confirmed by a blood test. But a blood test may not reveal infection in people who have been receiving antibiotics. Some infections that can cause sepsis cannot be diagnosed by a blood test.
Other tests that may be done include:
- Blood gases
Blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Kidney function tests
Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...
Read Article Now Book Mark Article - Platelet count, fibrin degradation products, and coagulation times (PT and PTT) to check for bleeding risk
Platelet count
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are particles in the blood that help the blood clot. ...
Read Article Now Book Mark ArticleFibrin degradation products
Fibrin degradation products (FDPs) are the substances left behind when clots dissolve in the blood. A blood test can be done to measure these produc...
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Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. It measures the functio...
Read Article Now Book Mark ArticlePTT
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem...
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White blood cell count
A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood. It is a part of a complete blood count (CBC). WBCs are a...
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White blood cell differential
The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...
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Treatment
A person with sepsis will be admitted to a hospital, usually in the intensive care unit (ICU). Antibiotics are usually given through a vein (intravenously).
Other medical treatments include:
- Oxygen to help with breathing
- Fluids given through a vein
- Medicines that increase blood pressure
- Dialysis if there is kidney failure
Dialysis
Dialysis treats end-stage kidney failure. It removes harmful substances from the blood when the kidneys cannot. This article focuses on peritoneal d...
Read Article Now Book Mark Article - A breathing machine (mechanical ventilation) if there is lung failure
Mechanical ventilation
A ventilator is a machine that breathes for you or helps you breathe. It is also called a breathing machine or respirator. The ventilator: Is attac...
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Outlook (Prognosis)
Sepsis is often life threatening, especially in people with a weak immune system or a long-term (chronic) illness.
Damage caused by a decrease in blood flow to vital organs such as the brain, heart, and kidneys may take time to improve. There may be long-term problems with these organs.
Prevention
The risk of sepsis can be reduced by getting all recommended vaccines.
In the hospital, careful hand washing can help prevent hospital-acquired infections that lead to sepsis. Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis.
References
Shapiro NI, Jones AE. Sepsis syndrome. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 127.
Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-810. PMID 26903338 pubmed.ncbi.nlm.nih.gov/26903338/.
van der Poll T, Wiersinga WJ. Sepsis and septic shock. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 73.
Intensive care unit (ICU) - illustration
An intensive care unit (ICU) is a section of a hospital or health care facility that provides care for patients with life-threatening health problems. These patients need constant monitoring and treatment, which may include support for vital functions. Common types of equipment used in the ICU include cardiac monitoring, mechanical ventilation, feeding tubes, intravenous lines, drains, and catheters. The ICU may also be called an intensive therapy unit or critical care unit.
Intensive care unit (ICU)
illustration
Intensive care unit (ICU) - illustration
An intensive care unit (ICU) is a section of a hospital or health care facility that provides care for patients with life-threatening health problems. These patients need constant monitoring and treatment, which may include support for vital functions. Common types of equipment used in the ICU include cardiac monitoring, mechanical ventilation, feeding tubes, intravenous lines, drains, and catheters. The ICU may also be called an intensive therapy unit or critical care unit.
Intensive care unit (ICU)
illustration
Review Date: 9/10/2022
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.