Sepsis

Also called Blood Poisoning

Sepsis is a potentially deadly illness that results in the bloodstream being overwhelmed by bacteria. The end result is hypotension, coma and rapid heartbeat. It is a highly dangerous condition.

The causes of sepsis include those conditions that allow bacteria to enter the bloodstream. These can include bowel diseases, such as peritonitis, which can result from a puncture in the bowel. The other causes include the kidneys, which can result from a urinary tract infection letting blood get into the bloodstream, the lining of the brain or (meningitis), the liver or the gallbladder, which can become infected, the lungs, which can result in a pneumonia, and a cellulitis or skin infection. In children, you can get sepsis from a bony infection called osteomyelitis. In patients who reside in a hospital, sepsis can include infection caused by an IV site, a surgical wound or surgical drains. Anywhere the skin breaks down can cause a cellulitis and secondary sepsis.

Symptoms of sepsis include a drop in blood pressure so that the patient has hypotensive shock. The kidneys, lungs, CNS, and liver cease to get enough blood perfusion and they begin to fail. Secondary organ failure is common. Signs and symptoms of sepsis include chills, decreased urine output, confusion, delirium, fever, hyperventilation, light headedness, rapid heart rate, skin rash, hot sweaty skin and shaking. The level of consciousness can worsen to the point of unconsciousness.

Examinations to determine the presence of sepsis include a history and physical examination. Blood cultures can, over a day or two, tell if bacteria are growing in the normally sterile blood. Blood gases can show a lack of oxygenation of the blood and metabolic acidosis; kidney function can be abnormal; the platelet count can be low and the white blood cell count can be high. There can be a predominance of leukocytes in the blood, trying to fight off the infection. A peripheral smear and a fibrin degradation product test can be done as well.

The treatment of sepsis requires hospitalization and aggressive care, including treatment in an ICU and IV antibiotics in order to kill off the infection. The underlying problem is addressed and treated as well, usually with the same antibiotics. Antibiotics include broad spectrum antibiotics, particularly those for gram negative and gram positive coverage. Often more than one antibiotic is used in order to be sure that the antibiotics kill the bacteria. Oxygen is given to maximize the oxygen level in the bloodstream. Fluids are given through an IV to keep the patient hydrated. In some cases medications are given to raise the blood pressure and dialysis is done for kidney failure. Mechanical ventilation is used if the person isn't breathing properly. Some patients are treated with corticosteroids or with recombinant human activated protein C, which control the massive amount of inflammation going on in the body during sepsis.

The prognosis of sepsis depends on the strength of your immune system and whether or not you have an underlying chronic disease. About a million people a year develop sepsis and of these, one in three dies within the first month after having the septic event.

Complications of sepsis depend on how ill you are at the time of the sepsis and on the strength of your immune system. If you have diabetes or other health condition, your chances of dying are greater than average. Death is a common complication of sepsis and disseminated intravascular coagulation can happen with sepsis. There can be problems with blood flow to the major organs, including the heart, liver, kidneys and brain. This can cause damage to these organs. You can also get septic shock, which is a low blood pressure condition that can be deadly.