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Sepsis
Also called Septicemia
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Sepsis or septicemia is a blood borne infection that is potentially life threatening. Your immune system is remarkably responsive to bacteria in the bloodstream so that it begins to injure body tissues. Organs can malfunction and the blood pressure can drop, leading to septic shock. Septic shock can be fatal. People who get sepsis include those who have a compromised immune system,, those who are very young or very old, hospitalized individuals and those who have breathing tubes, urinary catheters or other invasive devices in their body.
There are several symptoms to be aware of when suspecting sepsis or septicemia. This includes a fever of 101 degrees F or more or a very low temperature of 95 degrees F or less. The heart rate is around 90 or more (and sometimes much higher than that) and the respiratory rate is higher than 20 breaths per minute. There may be a confirmed infection in one or more organ systems of the body, such as the bowel or the urinary tract.
Severe sepsis involves mottled skin, decreased urine output due to urinary failure (kidney failure), decreased platelet count, problems breathing, change in mental status and abnormal heart function. If you have septic shock, you have a markedly low blood pressure due to severe infection.
Causes of sepsis are a bacterial infection that has triggered the immune system to fight back. In sepsis, the immune system is overactive and exaggerated so that the entire body is affected. There are small, microscopic clots forming in the blood vessels that take up clotting factors so that you can get bleeding in other body areas. The tiny clots can't be broken down easily and there are fewer normal blood cells to carry oxygen throughout the body. Your organs fail because they do not receive enough oxygen.
Risk factors for sepsis include being an infant or being older than age 65. It is more prevalent in African Americans than in Caucasian people. Black men have the highest risk of sepsis. If your immune system is weak due to cancer or cancer treatment, anti-rejection drugs in organ transplantation, HIV/AIDS, liver failure or kidney failure. If you are in a hospital, you are more likely to get sepsis. If you have a catheter in the bladder, an artificial joint or a breathing tube in, you are more likely to get septic.
Sepsis also can happen if you have pneumonia, diabetes, severe trauma or severe burns, surgery or bacteria in the blood, called bacteremia. There also appears to be a genetic component to those who get septicemia.
If the septicemia or sepsis is mild, only about fifteen percent die. If the sepsis is severe and involves organ failure and small blood clots with a bleeding disorder in the system, the mortality rate is nearly fifty percent.
The diagnosis of sepsis is tough because it can mimic other diseases. Doctors look for fever, low blood pressure, change in mental status and organ damage in order to diagnose septicemia. White blood cell counts tend to be high and a blood culture is likely to show the presence of bacteria growing in the blood. There can be gross evidence of infection in body areas such as the sites of appliances in the body or abscess formation in the chest or abdomen. Electrolyte disturbances are also common in sepsis.
The doctor can do blood cultures, urine cultures, cultures of wound secretions and cultures of the cerebrospinal fluid to detect the source of the infection. Sometimes the source can't be found and the infection is just in the bloodstream. Doctors can also do a CT scan or MRI scan to look for abscesses in the chest or abdomen. An ultrasound can sometimes show the presence of abscesses.
The treatment of sepsis must be early and aggressive if the patient is going to live. Close monitoring of the body systems in the intensive care unit is required. Antibiotics must be used immediately to try and fight the infection. Medications to keep the blood pressure up are necessary until the body can maintain its blood pressure on its own. Corticosteroids and insulin may be required in order to stabilize the blood sugar and fight the overactive immune system. IV fluids work to maintain a normal blood pressure as well. Surgery might be necessary in order to get rid of implanted medical devices that are infected, remove drainage tubes or to drain abscesses.