Sepsis, also known as systemic inflammatory response syndrome, or SIRS, is an infection of the bloodstream. This potentially fatal condition occurs when the body's weakened immune system is unable to respond effectively to an infection. This condition most often affects infants, people over the age of 65, and those with weakened immune systems caused by serious illness or severe injury.
There are more cases of sepsis than there have been in the past. Reasons for this are speculated to be an increase in the number of drug-resistant bacteria, an aging population, the increasing number of surgeries performed, the longevity of patients with chronic diseases, and the more widespread use of immunosuppressive medications.
Causes of Sepsis
While sepsis may result from fungal, parasitic or viral infections, the most common cause of sepsis is a bacterial infection in any part of the body. Sepsis occurs when the body releases chemicals into the bloodstream in order to fight the infection. These chemicals can trigger major systemic inflammation that may lead to organ failure. If patients are treated early with intravenous antibiotics, they have the best chance of recovery. If sepsis progresses to septic shock and the patient's blood pressure drops dramatically, death is a greater possibility. Research has shown that every hour a patient with sepsis goes without antibiotic treatment, the risk of mortality increases.
Infections that result in sepsis may occur anywhere in the body. A septic reaction may occur following appendicitis, pneumonia, meningitis, osteomyelitis or an infection of the urinary tract. It may also occur after a severe injury or as a post-surgical infection. It is even possible for sepsis to occur following a small infection, such as a cut on the finger, which has been left to fester. Patients who have had a splenectomy are more susceptible to sepsis because of their compromised immune systems.
Symptoms of Sepsis
Patients with sepsis may experience the following symptoms:
- Fever or extremely low body temperature
- Elevated heart rate
- Nausea, vomiting or diarrhea
- Mottled skin
- Difficult or rapid breathing
- Altered mental status
- Low blood pressure
- Urinary retention
Diagnosis of Sepsis
Patients with sepsis experience inflammation that affects the whole body so diagnosis of the precipitating cause of the condition may be difficult. Tests conducted to confirm a diagnosis of sepsis may include:
- Blood tests
- Laboratory cultures
- Kidney or liver function tests
- Diagnostic imaging tests
Treatment of Sepsis
Treatment for sepsis takes place in the intensive care unit of a hospital. Patients are placed under close monitoring to ensure that treatment is effective. Treatment may include the following:
- Broad-spectrum intravenous antibiotics
- Vasopressors to increase blood pressure
- Intravenous fluids
- Oxygen administration
- Surgery to remove the source of infection
Depending on the severity of the sepsis, the patient may need the assistance of a breathing machine or require kidney dialysis.
Recovery from Sepsis
Sepsis is an extremely grave condition. Still, with modern medical intervention, most patients who become septic, as many as half survive the event. For those whose condition progresses to septic shock, the risk of death is greater. While some patients recover completely from sepsis, many have permanent organ damage resulting in physical or cognitive impairment.