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One of the leading killers around the world, including in the United States and the United Kingdom, is sepsis, a condition many people have never even heard of. Here is what you need to know if you are confronted by this potentially deadly condition.

In the English language, the ill-defined terms sepsis, septicemia, and septic shock refer to a a condition of systemic inflammation that can cause whole organ systems to shut down. For this article, we'll refer to all three conditions as "sepsis," which can refer to septicemia, a body-wide bacterial infection, systemic inflammatory response, a body-wide condition of inflammation, or both events occurring at the same time. Sepsis usually involves bacteria, but it can involve viruses, parasites, or fungi, and systemic inflammatory response can include pancreatitis, burns, and trauma. What you need to know to survive these conditions is the same for all.

The Symptoms Of Sepsis Are Insiduous And Vague

The initial symptoms of sepsis are hard to diagnose. The most common symptom in older people is not something you will usually read about online. It's confusion. Someone in the early stages of sepsis may suddenly start acting as if she or he had Alzheimer's. Then there can be anxiety. Someone who has sepsis may not want to go to see the doctor or go to the emergency room. Then as the problem progresses, there is no particular order in which organ systems will begin to run amock. There can be:

  • Neurological symptoms. These can include stiff neck, earache, sore throat, and "the worst headache ever," in addition to altered mental status.
  • Respiratory symptoms. Sepsis is more likely to cause a productive, "phlegmy" cough than a dry cough. There can be shortness of breath and difficulty breathing.
  • Gastrointestinal symptoms. Diarrhea is not unusual. Neither is abdominal tenderness. Swelling can occur where it is not expected, in places such as the rectum.
  • Bone and muscle symptoms. There can be joint pain, swollen muscles, and stiffness.
  • Urogenital symptoms. Urination may be scanty of difficult, and urine may be dark. There can be flank (kidney) pain.
  • Skin symptoms. The skin can appear bruised, either with tiny petecchiae or with larger blue and purple spots. It can blister.

The problem with getting a good diagnosis of sepsis is that any, all, or some of these symptoms can occur in any order. Sometimes all a patient will have to go on is the certain knowledge that "something is very wrong" and the only thing to do is to report to an emergency room.

Sepsis Leads To Shock

Once sepsis has set in, multiple organ systems begin to malfunction, resulting in shock. Basically, shock is the body's loss of the ability to maintain circulation. The heart may work very hard but be unable to circulate blood because blood vessels are dilated. The kidneys may not get enough circulation to keep producing urine. The skin may be pale, cool, and clammy, and the heart may beat fast (more than 90 beats per minute), breathing may be shallow but rapid (more than 20 breaths per minute), and body temperature may fluctuate, higher than 38°C (100.4°F) or lower than 36°C (96.8°F). All of these symptoms seem to result from an over-response of the immune system either to an infection, or to tissue injury and blood loss.

Continue reading after recommendations

  • Brun-Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA. Sep 27 1995. 274(12):968-74.
  • Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. Feb 2013.41(2):580-637.
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