Sepsis: Symptoms, Causes, Treatment & Risk

Sepsis is a potentially life-threatening condition caused by your body's response to an infection that damages its own tissues. Your immune system protects you from many illnesses and infections, but it's also possible for it to go into overdrive in response to an infection.

Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic shock.

This is a dramatic drop in blood pressure that can lead to severe organ problems and death.

Signs and symptoms of sepsis

a fever above 101ºF (38ºC) or a temperature below 96.8ºF (36ºC)
heart rate higher than 90 beats per minute
breathing rate higher than 20 breaths per minute
probable or confirmed infection
Change in mental status
Systolic blood pressure the first number in a blood pressure reading less than or equal to 100 millimeters of mercury (mm Hg)
Respiratory rate higher than or equal to 22 breaths a minute

Severe sepsis

Severe sepsis occurs when there's organ failure. You must have one or more of the following signs to be diagnosed with severe sepsis:

patches of discolored skin
decreased urination
changes in mental ability
low platelet (blood clotting cells) counts
problems breathing
abnormal heart functions
chills due to fall in body temperature
unconsciousness
extreme weakness

Causes

While any type of infection bacterial, viral or fungal can lead to sepsis, infections that more commonly result in sepsis include infections of:

Lungs, such as pneumonia
Kidney, bladder and other parts of the urinary system
Digestive system
Bloodstream (bacteremia)
Catheter sites
Wounds or burns

Septic shock

Symptoms of septic shock include the symptoms of severe sepsis, plus very low blood pressure.

Septic shock is a severe drop in blood pressure that results in highly abnormal problems with how cells work and produce energy. Progression to septic shock increases the risk of death. Signs of progression to septic shock include:

The need for medication to maintain systolic blood pressure greater than or equal to 65 mm Hg.
High levels of lactic acid in your blood (serum lactate). Having too much lactic acid in your blood means that your cells aren’t using oxygen properly.

How is sepsis diagnosed?

If you have symptoms of sepsis, your doctor will order tests to make a diagnosis and determine the severity of your infection. One of the first tests is a blood test. Your blood is checked for complications like:

infection
clotting problems
abnormal liver or kidney function
decreased amount of oxygen
an imbalance in minerals called electrolytes that affect the amount of water in your body as well as the acidity of your blood

Depending on your symptoms and the results of your blood test, your doctor may order other tests, including:

a urine test (to check for bacteria in your urine)
a wound secretion test (to check an open wound for an infection)
a mucus secretion test (to identify germs responsible for an infection)

If your doctor can't determine the source of infection using the above tests, they may order an internal view of your body using one of the following:

X-rays to view the lungs
CT scans to view possible infections in the appendix, pancreas, or bowel area
ultrasounds to view infections in the gallbladder or ovaries
MRI scans, which can identify soft tissue infections

How is sepsis treated?

Sepsis can quickly progress to septic shock and death if it's left untreated. Doctors use a number of medications to treat sepsis, including:

antibiotics via IV to fight infection
vasoactive medications to increase blood pressure
insulin to stabilize blood sugar
corticosteroids to reduce inflammation
painkillers

Severe sepsis may also require large amounts of IV fluids and a respirator for breathing. Dialysis might be necessary if the kidneys are affected. Kidneys help filter harmful wastes, salt, and excess water from the blood. In dialysis, a machine performs these functions. In some cases, surgery may be needed to remove the source of infection. This includes draining a pus-filled abscess or removing infected tissue.

Sepsis prevention

Taking steps to prevent the spread of infection can reduce your risk of developing sepsis. These include:

Staying up to date on your vaccinations. Get vaccinated for the flu, pneumonia, and other infections.
Practicing good hygiene. This means practicing proper wound care, handwashing, and bathing regularly.
Getting immediate care if you develop signs of infection. Every minute counts when it comes to sepsis treatment. The sooner you get treatment, the better the outcome.

Who is at risk for sepsis?

Although some people have a higher risk of infection, anyone can get sepsis. People who are at risk include:

young children and seniors
with weaker immune systems, such as those with HIV or those in chemotherapy treatment for cancer
people being treated in an intensive care unit (ICU)
people exposed to invasive devices, such as intravenous catheters or breathing tubes