What is Sepsis?

Q: I heard that an old college friend was diagnosed with sepsis and had to take a long course of antibiotics. What is sepsis?

A: Sepsis is a serious medical condition caused by an overwhelming immune response to infection. Chemicals released into the blood to fight infection trigger widespread inflammation, which may result in organ damage.

Sepsis occurs in 1 percent to 2 percent of all hospitalizations in the U.S. It affects at least 750,000 people each year. Bacterial infections are the most common cause of sepsis, however, the infection can begin anywhere bacteria or other infectious agents can enter the body. It can result from something as seemingly harmless as a scraped knee or nicked cuticle or from a more serious medical problem such as appendicitis, pneumonia, meningitis or a urinary tract infection.

Sepsis may have different symptoms due to beginning in different parts of the body. Rapid breathing and a change in mental status, such as reduced alertness or confusion, may be the first signs that sepsis is starting. Other common symptoms include:

Fever and shaking chills or, alternatively, a very low body temperature

  • decreased urination

  • rapid pulse

  • rapid breathing

  • nausea and vomiting

  • diarrhea

Quick diagnosis is the first step to successful treatment. If sepsis is suspected, the doctor will perform an exam and run tests to look for:

  • Bacteria in the blood or other body fluids

  • Source of the infection, using radiologic imaging such as X-ray, CT scan, or ultrasound

  • A high or low white blood cell count

  • A low platelet count

  • Low blood pressure

  • Too much acid in the blood (acidosis)

  • Altered kidney or liver function

People diagnosed with severe sepsis are frequently placed in the intensive care unit, where doctors try to stop the infection, keep vital organs functioning, and regulate blood pressure. Blood clotting during sepsis reduces blood flow to limbs and internal organs, depriving them of nutrients and oxygen. In severe cases, one or more organs fail. In the worst cases, infection leads to a life-threatening drop in blood pressure, called septic shock. This can quickly lead to the failure of several organs, causing death.

Once the infectious agent is identified, the doctor can switch to a drug that targets that particular agent. Depending on the severity and effects of sepsis, other types of treatment, such as a breathing machine or kidney dialysis, may be needed. Sometimes surgery is necessary to drain or clean an infection. 

Today’s expert is Sarah Haroldson, MD, ThedaCare Physicians-New London.