You may have heard the word and wondered what it is, how do you get it and how to keep from getting it. SEPSIS is when an infection on or in your body gets out of control and its detrimental effects spread to organs outside of the original site where the infection started. It’s interesting because it’s not necessarily the bacteria itself, but our own immune system gone haywire in response to an infection. It’s frightening because it’s life-threatening, difficult to treat, and can lead to organ failure and death. Sepsis can start from a skin infection or a lung infection; the most important thing to remember is to see a doctor or go to the emergency room for any infection that is lingering over several days to a week, and if on treatment, return if symptoms don’t improve.
WHO IS AT RISK FOR SEPSIS?
The very young and the very old (yes over 65!) are at the top of the list, but also people who are pregnant, have chronic disease like diabetes, kidney failure, obesity, cancer and/or a weakened immune system. Patients hospitalized with serious illness (in the ICU) or burns, or have catheters, IVs and breathing tubes are also at risk.
While most people will not develop sepsis from an infection, about 1.7 million cases occur yearly.
HOW DOES IT HAPPEN?
Usually sepsis develops from a bacterial infection, although a virus, fungus, parasite or combination (= superinfection) can trigger the condition. First, the pathogen spreads to the bloodstream, second comes sepsis, and third comes septic shock. When the infection goes untreated, or the treatment doesn’t work adequately to control the infection, the body’s own infection-fighting mechanisms kick into high-gear causing damage to end organs (such as the heart, lungs, liver, kidneys, brain and gastrointestinal tract). The “immune” system releases many factors from the blood and lymphatics that cause widespread inflammation and blood clotting abnormalities, which in turn will escalate treatment modalities and require medical experts in multiple specialties.
Septic shock often presents a dire prognosis; death can ensue as soon as 12 hours after onset, and 30% to 40% will die even with treatment.
WHAT ARE THE SYMPTOMS AND CAUSES?
Fatique; feeling slow, weak, hot or cold/shivering, lightheaded, short of breath, exaggerated pain and lack of urination; low blood pressure and possibly a rash.
Underlying causes are typically from pneumonia, urinary tract infections, ruptured bowel (like in some cases of appendicitis), and advanced skin infections like cellulitis.
Fortunately, sepsis itself is not contagious, but the underlying infection could be.
DIAGNONSIS AND TREATMENT
Immediate assessment and therapy are the keys to successful treatment of sepsis; do not ignore your body if its not feeling well! Pay attention to the signs above. Emergency room care will include a thorough history, vital signs and physical exam, IV fluids and initial blood tests and urinalysis. Imaging like x-ray, ultrasound and CT scan will likely be ordered, and a broad-spectrum antibiotic (one that is not necessarily specific to the offending bacteria) started until blood culture results come back. Depending on which stage is presented, care in the ICU may be needed for advanced pulmonary and/or kidney support; surgery also may be indicated.
If sepsis is survived there may be long-term sequeli. Patients may experience cognitive decline, insomnia, panic attacks and nightmares. And they may be at risk for another episode of sepsis. Recovery in general will be a long road back to wellness; physical and emotional therapy will be needed and can help tremendously.
PREVENTION
To say “just don’t get sick” might work, but infectious disease isn’t always avoidable. A few basics can go a long way:
–hand wash frequently
–stay up to date with vaccines
–mask up when appropriate
–eat a healthy diet
–don’t let small wounds fester, continue treatment and antibiotics for the recommended time
References:
My.clevelandclinic.org
Mayoclinic.org
Who.int…sepsis