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Sepsis

Definition

Sepsis is an illness in which the body has a severe response to bacteria or other germs.

This response may be called systemic inflammatory response syndrome (SIRS).

Causes

The symptoms of sepsis are not caused by the germs themselves. Instead, chemicals the body releases cause the response.

A bacterial infection anywhere in the body may set off the response that leads to sepsis. Common places where an infection might start include the:

For patients in the hospital, common sites of infection include intravenous lines, surgical wounds, surgical drains, and sites of skin breakdown, known as bedsores or pressure ulcers.

Symptoms

In sepsis, blood pressure drops, resulting in shock. Major organs and body systems, including the kidneys, liver, lungs, and central nervous system stop working properly because of poor blood flow.

A change in mental status and very fast breathing may be the earliest signs of sepsis.

In general, symptoms of sepsis can include:

Bruising or bleeding may also occur.

Exams and Tests

The health care provider will examine the person and ask about the person's medical history.

The infection is often confirmed by a blood test. But a blood test may not reveal infection in people who have been receiving antibiotics. Some infections that can cause sepsis cannot be diagnosed by a blood test.

Other tests that may be done include:

Treatment

A person with sepsis will be admitted to a hospital, usually in the intensive care unit (ICU). Antibiotics are usually given through a vein (intravenously).

Oxygen is given to the person. Large amounts of fluids are given through a vein. Other medical treatments include:

  • Medicines that increase blood pressure
  • Dialysis if there is kidney failure
  • A breathing machine (mechanical ventilation) if there is lung failure

Outlook (Prognosis)

Sepsis is often life threatening, especially in people with a weakened immune system or a long-term (chronic) illness.

Damage caused by a drop in blood flow to vital organs such as the brain, heart, and kidneys may take time to improve. There may be long-term problems with these organs.

Not all patients survive an episode of sepsis.

Prevention

The risk of sepsis can be reduced by getting all recommended vaccines.

In the hospital, careful hand washing can help prevent infections that lead to sepsis. Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis.

References

Munford RS, Suffredini AF. Spesis, severe sepsis, and septic shock. In: Bennett JE, Dolin R, Mandell GL, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 75.

Russell JA. Shock syndromes related to sepsis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 108.


Review Date: 8/31/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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