A recent report from the U.S. Centers for Disease Control and Prevention (CDC) urges people to learn the signs and symptoms of sepsis—a body's overwhelming and life-threatening response to an infection—and to seek emergency medical care immediately if sepsis is suspected.
Usually a person's immune system recognizes and contains a bacterial infection to a specific site, such as the lungs, skin, or urinary tract. However, some infections may spread from the original site of infection to the blood and possibly other sites of the body. To attempt to control the infection, the immune system may produce an exaggerated, widespread inflammatory response that affects the whole body (systemic). This reaction, called sepsis, can cause a significant rise or fall in body temperature, increased heart and breathing rates, and if it progresses to severe sepsis, a dangerous drop in blood pressure, which may result in tissue damage, organ failure, and death.
"When sepsis occurs, it should be treated as a medical emergency," says CDC Director Tom Frieden, M.D., M.P.H. "Doctors and nurses can prevent sepsis and also the devastating effects of sepsis, and patients and families can watch for [the condition] and ask, 'could this be sepsis?'"
Sepsis is more common in newborns, infants, and in the elderly, but other people at risk include post-surgery patients, people with internal medical devices such as catheters, people with chronic illnesses such as diabetes, and people with weakened immune systems. According to the CDC report, more than 90% of adults and 70% of children who developed sepsis had a condition that put them at risk. While less common, even healthy children and adults can develop sepsis from an infection that can progress if not recognized early and treated.
Infections that most commonly lead to sepsis include those of the lung (pneumonia), urinary tract, skin, and digestive tract. Common bacteria that can trigger sepsis include Staphylococcus aureus, Escherichia coli (E. coli), and some types of Streptococcus.
One reason sepsis can be so hard to detect is that 80% of people who develop the reaction do so outside the hospital where it can be difficult to identify the severe reaction occurring. However, according to the CDC report, about 70% of people who develop sepsis had used health services recently or have a chronic condition that requires frequent medical attention. Such patients are at risk for sepsis and their caregivers and healthcare practitioners should be looking for and able to recognize the signs and symptoms of sepsis. These can include:
- Fever, shivering, chills
- Clammy or sweaty skin
- Extreme pain or discomfort
- Confusion or disorientation
- Rapid breathing
- Rapid heart rate
Diagnosing sepsis can be difficult. The criteria for diagnosis include body temperature, fast heart rate and respiratory rate, plus a probable or known infection.
There is no single test that can identify sepsis. Healthcare practitioners typically order a combination of tests to detect the inflammation associated with sepsis and to evaluate and monitor the patient. Examples include tests for lactate, C-reactive protein, procalcitonin, blood gases, and a comprehensive metabolic panel. Cultures of the blood and/or urine as well as other body fluids or from other body sites are usually done to help identify the source of the infection. (For more details, read Sepsis: Tests.)
If not treated quickly and successfully, sepsis can progress to severe sepsis or eventually to septic shock. If a person's blood pressure remains low for an extended period of time, there is an insufficient blood supply to vital organs, which can fail and cause death.
The death rate for sepsis ranges from 25% to 50% of patients, according to the CDC, which is why it's important to identify sepsis and start treatment as soon as possible. Though many people completely recover from sepsis, those who suffered organ damage such as kidney failure may need treatment for the rest of their life.
Healthcare practitioners, patients, and family members can all help prevent sepsis by following good infection control practices, such as frequent and thorough hand washing. Some causes of sepsis can also be prevented by being up to date on vaccinations, such as for flu and pneumonia, and taking care to manage any chronic conditions.