Sepsis occurs when your body goes into overdrive trying to fight an infection and instead turns on itself, creating a toxic situation that can lead to tissue damage and organ failure. Sepsis can become life-threatening very quickly and medical attention is needed immediately. Here’s what you need to know about sepsis, what symptoms to look out for, and how it is diagnosed and treated.
What Is Sepsis?
Your immune system is armed to protect you against invading viruses, bacteria, parasites, and fungi. However, there are times when the chemicals released by your immune system that normally fight off these invaders cause inflammation that spreads throughout the body. This overwhelming reaction of your body to this unwieldy inflammatory response is called sepsis.
Sepsis is a life-threatening illness because a domino effect can occur, where blood flow decreases due to blood clots and leaky blood vessels, blood pressure drops, and organs can be weakened, damaged, and potentially fail. According to the Centers for Disease Control and Prevention (CDC), the number of sepsis cases in the United States increases every year. In fact, the NIH reports that in the U.S., sepsis causes more deaths than breast cancer, prostate cancer, and AIDS combined.
What Causes Sepsis?
A variety of infections can be responsible for leading to sepsis, but most common infections of the kidneys, blood, and stomach are to blame. The source of infection can also come from your skin, urinary tract, or lungs. E. coli, Staphylococcus aureus, and Streptococcus are the most common causes of a bacterial infection that leads to sepsis. If an infection spreads to your bloodstream, it can progress to severe sepsis and you will most likely need medical care in an intensive care unit. There are incidents where bacteria is introduced to your body via a catheter or IV tube while being treated for another illness, and without proper immune function the infection spreads.
Who Gets Sepsis?
Sepsis can affect anyone, but babies younger than a year old, people 65 years and older, and individuals with compromised immune systems or chronic illnesses are at a higher risk. If you have a chronic condition like kidney disease, diabetes, cancer, or lung disease, your chances of developing sepsis are higher too. Severe sepsis affects more than a million Americans annually, and 15% to 30% of those cases are fatal.
Sepsis has three stages, beginning with sepsis, progressing to severe sepsis, and potentially leading to septic shock, a life-threatening situation. Symptoms of sepsis can include a combination of signs or only one. You may experience:
- High fever
- Rapid breathing
- Sweaty or clammy skin
- Increased heart rate
- Disorientation or confusion
Your condition can turn into severe sepsis when your vital organs and tissues become damaged from the increased inflammation and deteriorating functions of the body. Your skin may become discolored or you may have an irregular heartbeat and difficulty breathing, become extremely weak, experience decreased urination, and even lose consciousness. Severe sepsis can have lasting effects on the body, leaving you more susceptible to other infections in the future.
If your condition proceeds into septic shock, you may experience a drastic drop in blood pressure. Other symptoms of septic shock include a rapid heart rate and affected mental status. This is a serious medical emergency since around 50% of people who have septic shock do not survive.
How Is Sepsis Diagnosed?
Your doctor will discuss your symptoms, any ongoing conditions, and your medical history. A blood test may be ordered to look at your white blood cell count and to see if bacteria or another type of infection is present. Blood results can also reveal oxygen and electrolyte levels and the condition of your kidneys and liver. A chest X-ray or CT scan can also help diagnose your condition and identify if you have an infection, where the infection lies, and how your organs are functioning.
Doctors assess the severity of the sepsis infection using the systemic inflammatory response syndrome (SIRS). SIRS is defined by a diagnosis of two or more of the following:
- Fever higher than 100.4 °F (38 °C) or less than 96.8 °F (36 °C)
- Heart rate that exceeds 90 beats per minute
- Respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO2) of less than 32 mm Hg
- Abnormal white blood cell count
The severity of sepsis is also determined by the quick sequential organ failure assessment (qSOFA), which doesn't require any lab tests and measures three criteria:
- Low blood pressure
- High respiratory rate (greater than 22 breaths per minute)
- Glasgow coma scale score of less than 15 (used to assess your level of consciousness)
Meeting two or more of the above criteria means you have a positive qSOFA.
Treatment of Sepsis
The biggest goal of treating sepsis is to eliminate the infection, maintain steady blood pressure, and protect against tissue damage and organ dysfunction. Immediate medical attention is essential to prevent sepsis from progressing into septic shock or death.
If your doctor suspects sepsis, you will head to the ICU for medication and monitoring. You may be given an IV of antibiotics to begin clearing the infection, intravenous fluids, insulin to normalize blood sugar, medication to minimize inflammation and lessen pain, and medication to increase blood pressure if necessary.
If you are in a life-threatening situation and your condition is poor, you may need dialysis or breathing assistance to lessen the stress on your organs. If the infection is serious, it may need to be surgically removed to prevent further spreading. Unfortunately, there is no one medicine that can reverse sepsis or the attack of your immune system. Doctors typically employ a combination approach of various drugs and methods.
Recovery time will vary from person to person, according to the stage of sepsis and additional ailments or health concerns. If medical attention is received promptly and no organs or tissues are permanently damaged, a full recovery is likely. If you or someone you know has been fighting an infection and begin to show any signs of sepsis, get to a doctor as soon as possible. Always wash hands well and keep any wounds clean and bandaged until completely healed to prevent infection.