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Sepsis and Septic Shock: Understanding Serious Infections

Diagnosis and Treatment of Sepsis and Septic Shock

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Updated January 21, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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What Is Sepsis?

A typical infection, such as an infection in a surgical incision, usually remains in one place. Sepsis happens when a localized infection moves into the bloodstream and then spreads through the body, leading to a massive inflammatory response by the body, causing irregular body temperatures (either too high or too low), and disruptions in breathing, among other problems. Septic shock is more severe, leading to organ dysfunction and low blood pressure that isn't fixed by fluids, and requires medications to increase pressure.

While bacteria is often responsible for sepsis, it can also be caused by fungi entering the bloodstream.

Preventing Sepsis

The only prevention for sepsis is to prevent infection. Standard infection prevention techniques, such as good wound care and frequent hand washing, can reduce the risk of infection.

Risk Factors For Sepsis and Septic Shock

While there are risk factors for sepsis and septic shock, healthy people with no risk factors can and do become ill due to sepsis. Some people are not even aware that they have an infection before it enters the blood stream and becomes more serious.

  • Multiple sources of infection
  • Surgery
  • Immune problems
  • IV drug abuse
  • Presence of a chronic illness, such as diabetes
  • Presence of a fatal illness
  • Artificial joint replacement
  • Heart valve replacement
  • Newborn or over the age of 35
  • Pregnancy

Sepsis Diagnosis

Sepsis is typically diagnosed through blood tests. Blood cultures and another blood test called a Complete Blood Count (CBC) are typically performed if there is suspicion of sepsis. Blood is drawn and sent to a lab where the CBC is typically completed in about an hour. A finding of elevated numbers of white blood cells is consistent with the presence of infection, but not necessarily sepsis. To confirm a diagnosis of sepsis, blood is incubated for five days to see if any bacteria grows. A normal blood culture would have no bacteria present at the end of testing. If bacteria is present, a sensitivity is performed, which is a further test to see what antibiotics can be used to treat the bacteria.

Sepsis VS Septic Shock

Symptoms of Sepsis:

One of the difficulties in diagnosing sepsis quickly and accurately is the symptoms are easily confused with common illnesses, such as food poisoning or the flu. Sepsis is relatively rare compared with the common flu, so it often isn't suspected until the individual becomes sicker.

  • Chills
  • Nausea
  • Vomiting
  • Fever

Sepsis is typically treated with antibiotics and close monitoring. Sepsis does progress to septic shock in some cases, so it is essential to watch for signs and symptoms that the condition is not responding to treatment or is worsening.

Symptoms of Septic Shock

  • Altered mental status
  • Difficulty oxygenating (diagnosed with special equipment or a blood test called an ABG
  • Low blood pressure
  • Rapid heart rate
  • Rapid breathing
  • Low urine output

Septic shock may progress to include organ failure and severe low blood pressure, and will require treatment with IV medications including antibiotics and medication to improve blood pressure. Patients who develop septic shock are typically unconscious and are intubated and placed on a ventilator to help support their breathing.

A diagnosis of septic shock is extremely serious and can result in death, even with prompt and appropriate critical care.

Sources:

Blood Cultures. Lab Tests Online. Accessed October, 2011. http://labtestsonline.org/understanding/analytes/blood-culture/tab/test

Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA. Accessed October, 2011.http://www.ncbi.nlm.nih.gov/pubmed/7674528

Sepsis and Septic Shock. Merck Manual. Accessed October, 2011. http://www.merckmanuals.com/home/infections/bacteremia_sepsis_and_septic_shock/sepsis_and_septic_shock.html

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