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Sepsis, sometimes referred to as Septicemia or blood poisoning, is a potentially life-threatening complication from an infection that is not treated. The Centers for Disease Control and Prevention estimates that more than one million people are treated every year in the United States for sepsis. Unfortunately, more than 25 percent of these people will die.
When the body detects an infection, it releases chemical substances into the bloodstream. This reaction produces an inflammatory response as the body’s immune system becomes activated. The problem is that the body’s inflammatory response to the chemicals released to counteract the infection can be so extensive that it blocks oxygen and critical nutrients from getting to the body’s organs. This can cause a patient to develop septic shock.
Sepsis has 3 recognized states. It begins sepsis, progresses to severe sepsis and culminates in septic shock. Because each state becomes progressively more dangerous to the patient, early diagnosis and treatment to stop this progression is vital to patient outcome. Once sepsis evolves to septic shock, the patient’s vital organs become at risk for failing.
WHO IS AT RISK?
Any infection can lead to sepsis. However, infections that begin in the bowel (peritonitis), bladder (pyelonephritis), bloodstream (from IV’s), surgical incisional wounds, the lungs (pneumonia), and the skin (Staph bacteremia) are typical infection sites that can lead to sepsis.
Although anyone can develop sepsis, the following individuals are increased risk:
- Age 65 and older
- People with blood-borne infection
- Patients with a compromised immune system
- Cancer patients
Unfortunately, the signs and symptoms associated with sepsis occur in many, much less serious conditions. As a result, the potential for sepsis is often overlooked. Nonetheless, the signs and symptoms of sepsis can include:
- High fever (more than 101 degrees)
- Low fever (less than 96 degrees)
- IncreasedIncreased heart rate (higher than 90 beats per minute)
- Increased respiratory rate (higher than 20 breaths per minute)
- Extremely elevated white blood count
In those patients who appear to be more ill than expected for their symptoms, sepsis
needs to be considered and ruled out.
For those patients with suspected sepsis, evaluation of their white blood count, SED rate and C-reactive protein level, will help determine generally whether a patient is suffering from an infection. However, a blood culture will permit identification of the specific bacterial organism causing the patient’s infection.
Because it often takes several days for the blood cultures to identify the exact organism causing the infection, a patient with a suspected infection is often started on what is known as a broad-spectrum antibiotic. Once the correct organism is identified, the antibiotic medications can be targeted to fight the specific bacteria that is causing the infection. In patients who are septic, it is sometimes necessary to support them with oxygen and fluids.
Sepsis that progresses from severe sepsis to septic shock can lead to catastrophic results. While sepsis can be effectively treated, those patients who are elderly, very young, or who have weakened immune systems, are less likely to be able to combat sepsis and their prognosis is typically worse.
Those patients who are fortunate to survive sepsis, often experience lengthy hospitalizations, organ failure, extensive rashes, and difficult recoveries. One of the very rare, but worst complications of severe sepsis, is the loss of fingers and toes from peripheral vascular gangrene.