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Septicemia
Also called Sepsis
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Sepsis is a life threatening blood condition that results from bacteria invading the blood stream and the secondary immune reaction to the bacteria. It can affect the function of the body's organs and can lead to septic shock due to an unhealthy drop in blood pressure.
Those at greatest risk of developing sepsis include the elderly and infants. Those who have a compromised immune system will have a higher likelihood of getting sepsis. People who are otherwise sick in the hospital are at higher risk for sepsis and those who have breathing tubes or other invasive devices in their body seem to be at higher risk for getting sepsis.
Sepsis has three stages: 1) sepsis, 2) severe sepsis and 3) septic shock. If you can treat sepsis in its most mild stages, it has a better prognosis and the individual has a better chance of survival.
The diagnosis of sepsis involves at least two of the following signs and symptoms:
- Heart rate over 90 beats per minute
- Fever of greater than 101.3 degrees or less than 95 degrees
- Respiratory rate greater than 20 breaths per minute
- Known or probable infection somewhere in the body
Severe sepsis involves the following symptoms and signs:
- Mottled skin
- Poor urine output
- Low platelet count
- Change in mental status
- Problems breathing
- Poor heart functioning
If you have septic shock, you have all of the above signs and symptoms but also have extremely low blood pressure, known as hypotension.
The cause of sepsis is the inflammatory response to bacteria that is exaggerated and overwhelming to the system. The bacteria in the bloodstream are the trigger for the inflammatory response. Small clots form in the very small blood vessels in the body and you cannot break down the clots because of changes in the immune system. The blood can't reach the organs of the body and they begin to fail.
Risk factors for sepsis include being over the age of sixty five years or being an infant. Those who are African American are at higher risk for sepsis. Those with cancer, HIV, or are taking anti-rejection drugs are at higher risk for getting sepsis. Those with underlying liver or kidney failure are at higher risk. Hospitalized patients have sepsis more than those on the outside and those with invasive medical devices are at greater risk for sepsis. Certain medical conditions predispose you to having sepsis, including bacteria in the bloodstream, diabetes, severe injuries such as burns or gunshot wounds or pneumonia. There are some people who are genetically predisposed to having sepsis.
As mentioned, sepsis runs from less to more in severity. The greater the sepsis, the higher is the risk of organ damage to the heart, kidneys, liver and brain. Blood clots can be initiated in the extremities, leading to gangrene of part of the body. If you get to severe sepsis or septic shock, the rate of death is about 50 percent.
Tests for sepsis include blood testing for clotting ability, infection in the bloodstream, abnormal liver function, abnormal liver function, impaired oxygenation and electrolyte disturbances. The urine may show evidence of bacteria in it and wounds can be cultured for the type of bacteria causing the problem. In some cases, a spinal tap can be done that can show infection in the brain tissues.
An x-ray or CT scan can show evidence of abscesses in the body and ultrasound evaluation can show issues with abscess formation or infections in organs, such as the gallbladder. MRI scans can do the same thing.
Your chances of survival go up considerably if you are treated quickly and aggressively. You need to be in an intensive care unit and you need to be on life supportive measures.
Medications that work against sepsis include antibiotics, often multiple antibiotics, to kill the bacteria that are causing the sepsis to occur. At some point a specific antibiotic will be defined that can kill the bacteria specifically. Vasopressors are used to keep the blood pressure up so the organs get perfused properly. Low dose corticosteroids can block the immune response so the part of sepsis caused by an overactive immune system is blocked to some degree. The individual is also supported by nutrients, IV fluids and oxygen. Surgery can be done to remove abscesses, get rid of drainage tubes causing infection and to get rid of any medical devices that are the cause of sepsis.