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Septic shock

Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Septic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.

Causes

Septic shock occurs most often in the very old and the very young. It may also occur in people with weakened immune systems.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage. This may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.

The body has a strong inflammatory response to the toxins that may contribute to organ damage.

Risk factors for septic shock include:

Symptoms

Septic shock can affect any part of the body, including the heart, brain, kidneys, liver, and intestines. Symptoms may include:

Exams and Tests

Blood tests may be done to check for:

Other tests may include:

Additional studies, such as blood cultures, may not become positive for several days after the blood has been taken, or for several days after the shock has developed.

Treatment

Septic shock is a medical emergency. In most cases, people are admitted to the intensive care unit of the hospital.

Treatment may include:

The pressure in the heart and lungs may be checked. This is called hemodynamic monitoring. This can only be done with special equipment and intensive care nursing.

Outlook (Prognosis)

Septic shock has a high death rate. The death rate depends on the person's age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started.

Possible Complications

Respiratory failure, cardiac failure, or any other organ failure can occur. Gangrene may occur, possibly leading to amputation.

When to Contact a Medical Professional

Go directly to an emergency department if you develop symptoms of septic shock.

Prevention

Prompt treatment of bacterial infections is helpful. Vaccination could help prevent some infections. However, many cases of septic shock cannot be prevented.

Related Information

Diabetes
Biliary system
Meningococcemia
Waterhouse-Friderichsen syndrome
Heart failure

References

Russell JA. Shock syndromes related to sepsis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 100.

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.

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Review Date: 12/6/2021  

Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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