Sepsis (Blood Infection)
Sepsis Overview
Sepsis is a condition in which your body is fighting a severe infection. If you become "septic," you will likely be in a state of low blood pressure termed "shock." This condition can develop either as a result of your body’s own defense system or from toxic substances made by the infecting agent (such as a bacteria, virus, or fungus).
People at risk
People whose immune systems (the body’s defense against microbes) are not functioning well because of an illness, such as cancer or AIDS, are more prone to have sepsis.
Because their immune systems are not completely developed, very young babies may get sepsis if they become infected and are not treated in a timely manner. Often, if they develop signs of an infection such as fever, infants have to receive antibiotics and be admitted to the hospital.
The elderly population, especially those with other medical illnesses such as diabetes, may be at increased risk as well.
The number of people dying from sepsis has almost doubled in the past 20 years. This is not because doctors cannot care for people who have sepsis but because the number of people who get sepsis has increased.
There has been a large increase because doctors have started treating cancer patients and organ transplant patients, among others, with strong medications that weaken the immune system.
Also, because of our aging population, the number of elderly people with weak immune systems has grown.
Finally, because of the overuse of antibiotics to treat illnesses caused by viruses and not bacteria, bacteria have become resistant, making the treatment of sepsis difficult in some cases.
Sepsis Causes
Many different microbes can cause sepsis. Although bacteria are most commonly the cause, viruses and fungi can also cause sepsis. Infections in the lungs (pneumonia), bladder and kidneys (urinary tract infections), skin (cellulitis), abdomen (such as appendicitis), and other organs (such as meningitis) can spread and lead to sepsis. Infections that develop after surgery can also lead to sepsis.
Who is at risk?
Very young people and elderly people
Anyone who has had a transplant
People who are being treated with chemotherapy drugs or radiation
People with long-standing diabetes, AIDS, or cirrhosis
Someone who has very large burns or severe injuries
People with infections such as the following:
Pneumonia
Meningitis
Cellulitis
Urinary tract infection
Ruptured appendix
Sepsis Symptoms
If you have sepsis, often you will have fever. Sometimes, though, the body temperature may be normal or even low.
You may also have chills and severe shaking.
Your heart may be beating very fast and your breathing rapid.
Confusion, disorientation, and agitation may be seen as well as dizziness and decreased urination.
Some people who have sepsis develop a rash on their skin. The rash may be a reddish discoloration or small dark red dots throughout the body.
You may also develop pain in the joints at your wrists, elbows, back, hips, knees, and ankles.
When to Seek Medical Care
When to call the doctor
You should call the doctor if you have signs and symptoms of sepsis and any of these situations:
You are being treated with chemotherapy or radiation.
You have had an organ transplant.
You are diabetic.
You have AIDS.
You are concerned that you may have sepsis and you develop fever or chills or any other signs and symptoms.
When to go to the hospital
If you have a child younger than 60 days with a fever, lethargy, poor feeding, change in normal behavior, or unusual rash, call your doctor and proceed to the hospital.
If you have a family member with confusion, dizziness, fast heartbeat, fast breathing, fever, chills, rash, or dizziness, call your doctor immediately or go to the hospital’s emergency department if you cannot reach your doctor in a timely manner.
Sepsis (Blood Infection)
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Exams and Tests
In the hospital, the doctor may conduct various tests.
Blood work may be done by inserting a needle into a vein in your hand or arm and drawing blood into several tubes. This blood may be analyzed to see if you have an elevation in the white blood cells.
Blood may also be sent to the lab to be placed on a medium where bacteria will grow if they are present in the blood. This is called a blood culture. Results from this test usually take over 24 hours. Lab technicians may also look for bacteria in the blood under the microscope on slides.
Samples may be taken of sputum (mucus), urine, spinal fluid, or abscess contents to look for the presence of germs.
To obtain clean urine and to measure the amount of urine you produce, a flexible rubber tube may be placed in your bladder.
Spinal fluid is obtained from the lower back. After the skin is cleaned and numbed, a hollow needle is placed between the bones of the spine into the canal containing the spinal cord. Because the needle is placed lower than where the cord ends, there is little danger of injuring the spinal cord. Sometimes you may experience electrical sensations or jolts in your legs during this test because the needle tickles the nerves as it goes in, but these sensations go away in a matter minutes in most cases. When the needle is in the correct spot, your doctor will let the fluid drip into tubes. These tubes are sent to the lab for testing. For the spinal tap, technicians may have to hold your child in the fetal position to allow the doctor to get the fluid without harming your child. You may be asked to leave the room during this test.
Other tests may include a chest x-ray to look for pneumonia or a CT scan to see if there is infection in the abdomen.
The CT scan is done while you lie on your back on a table. The scanner is a doughnut-shaped tube that you go through.
The radiology doctor may inject a dye into your vein during the test to help highlight certain organs in the abdomen. During the injection of this dye, you may feel a flushing or hot sensation or even become nauseated, but again this feeling will last a very short time.
The CT scan is a series of x-rays taken from different angles very quickly and put together by the computer to show an image of your abdominal contents.
Usually, a radiologist reads the results and notifies your doctor. If the test is done after hours, it may not be read until the next day.
In the hospital, you may be placed on a cardiac monitor, which consists of sticky knobs placed on your body and hooked up to a screen. This monitor will show your heartbeats.
If your young child is ill and being evaluated for sepsis, he or she will get similar tests and treatment.
Sepsis (Blood Infection)
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Sepsis Treatment
Self-Care at Home
Sepsis is a medical emergency. If you have sepsis, the treatment is usually given in the hospital and often in an intensive care unit.
Medical Treatment
You will likely be placed on oxygen, either by a tube that is placed near your nose or through a clear plastic mask.
Depending on the results of the tests, the doctor may order medications. These medications may include antibiotics given by IV. Initially the antibiotics may be those that kill many different bacteria because the exact kind of microbe you have is not known. Once the culture results show the identity of the bacteria, your doctor may select a different antibiotic that kills the specific microbe.
Your doctor may also order IV salt solution (saline) and medications called "pressors" to increase your blood pressure if it is found to be low.
The doctor will likely admit you to the hospital at least until the blood culture results are known. If you are very ill with a low blood pressure, your doctor may admit you to the intensive care unit (ICU) and may consult other doctors to help in the management of your illness.
If results show an infection in the abdomen, either drainage of the infection by tubes or surgery may be necessary.
Research to discover new treatments for sepsis have failed over the past 20-30 years. Many medications that were thought to be helpful were proven to have no benefit in clinical trials. However, scientists are working diligently to discover medications that will modify the body’s aggressive immune response to microbes, which leads to sepsis. New treatments and medications could be available in the near future.
Next Steps - Outlook
Your prognosis depends on your age and previous health.
If you are an elderly person with many illnesses or if your immune system is not working well because of illness or certain medications and sepsis is advanced, the death rate may be as high as 80%.
On the other hand, if you are a healthy person with no prior illness, the death rate may be low, at 5%.
The overall death rate from sepsis is around 40%. It is important to remember that your prognosis also depends on delay to diagnosis and treatment. The earlier the treatment is started, the better the outcome will be.
2007-06-06 15:10:08
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answer #9
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answered by Anonymous
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