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Sepsis or septicaemia is a severe medical problem that involves inflammation of the entire body and bacterial infection of the bloodstream. It is the immune system that triggers the response involved in sepsis and it can also come from infections of the urine, skin, lungs and other tissues besides blood, although blood is the most common source. Lay people call this condition blood poisoning. It is the infection plus the body's response to it that results in sepsis. It can result in low blood pressure and failure of the major organs, such as the heart, liver and kidneys.

Septicaemia is when the bacteria has affected the bloodstream and this results in the secondary features leading to full blown sepsis. In reality, you can have septicaemia but not have sepsis and you can have sepsis but not have septicaemia.

Sepsis is severe enough to need management in the intensive care unit with antibiotics, supportive medications and IV fluids. A vasopressor might be used to bring up the blood pressure in patients with low blood pressure and septicaemia. Sometimes mechanical ventilation is required along with dialysis for kidney failure. An arterial catheter and central venous catheter are used to measure the arterial blood pressure and venous pressure Prevention needs to be performed against stress ulcers, deep vein thrombosis and pressure ulcers. Blood glucose needs to be in tight control using an insulin drip or subcutaneous insulin. Corticosteroids can block some of the systemic response to bacteraemia.

One of the newer terminologies for sepsis is the term "systemic inflammatory response syndrome or SIRS". It means the body is undergoing an inflammatory response to something, in this case, bacteremia. Symptoms of sepsis or SIRS include difficulty breathing, clotting difficulties, altered mental state, and decreased urine output. There is low blood pressure, also called hypotension and hypoperfusion of at least one organ. In some cases there is lactic acidosis from a lack of perfusion of the muscles. Multiple organs can become dysfunctional in a condition known as multiple organ failure or multiple organ dysfunction syndrome. It results from a change in the blood flow shunting blood to the central part of the body and also from diffuse intravascular coagulation.

Remember that sepsis is the body's response to infection and is not the infection itself. The infection can be generalized to the blood in septicaemia or can be localized to one body area. It is more common for the infection to be localized to the bloodstream and not to a single organ of the body, however. Causes of sepsis include contact with someone who has sepsis and surgery. Injuries with dirty wounds can cause sepsis over time. Even tooth brushing can bring about bacteraemia and secondary sepsis if your immune system is not as good. Certain dental procedures can cause an infection on a damaged heart valve so that there can be sepsis secondary to this. Sepsis can be caused by having severe burns, multiple trauma, chemical pneumonitis and pancreatitis, in the absence of infection of the bloodstream.

The symptoms of sepsis include fever, high white blood count or low white blood count. You can even have a low blood pressure and low body temperature. There is dysfunction of the organs of the body, including the liver and the kidney. The respiratory rate and heart rate are high. A bacterium can often be grown from blood samples. If not treated, sepsis can easily lead to death.

The diagnosis of severe inflammatory response syndrome or sepsis is defined by having two or more of the symptoms noted above. Remember that SIRS can occur in the absence of a pathogen, while sepsis requires a pathogen, usually a bacterium in the bloodstream. In sepsis, you can find white blood cells in the cerebrospinal fluid and you can find evidence of a perforated part of the intestinal tract. The chest x-ray can show pneumonia and there can be skin purpura from clotting problems. End organ damage can include brain dysfunction, acute lung injury, acute respiratory distress syndrome or brain injury. Liver damage can result in a lack of clotting factors and kidney failure is possible. Heart failure is also possible.

Treatment of sepsis includes giving the person antibiotics by IV and draining any abscesses or fluid collections. Hemodialysis may be needed if the kidneys fail. Blood products might need to be replaced and mechanical ventilation may be required. Corticosteroids block the immune response in the body that is causing the sepsis. Vasopressors are used to keep the blood pressure normalized.

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