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Sepsis

Definition


Disease: Sepsis Sepsis
Category: Infectious diseases
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Disease Definition:

When the immune system's reaction to an infection injures the tissues of the body far from the original infection, it means that that person has a potentially life-threatening condition known as sepsis.

Sepsis could affect the function of the organs if it progresses, ultimately leading to septic shock, which is a drop in blood pressure that could be fatal.

People who are most at risk of developing sepsis are:

 

  • Those who have invasive devises, such as breathing tubes or urinary catheters
  • The very young and the very old
  • Very sick people in the hospital
  • Individuals with compromised immune systems


To improve chances of survival, early treatment should involve large amounts of intravenous fluids and antibiotics.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Sepsis is usually viewed as a three-stage syndrome, which starts with sepsis, progresses to severe sepsis, and then to septic shock. Treating sepsis during its mild stage and before it becomes more dangerous is the goal of treatment.

SEPSIS:
These are some of the symptoms that may indicate sepsis:

 

  • Respiratory rate higher than 20 breaths a minute
  • Fever above 38.5 C (101.3 F) or below 35 C (95 F)
  • Probable or confirmed infection
  • Heart rate higher than 90 beats a minute


In order to be diagnosed with sepsis, a person has to exhibit at least two of the symptoms mentioned above.

SEVERE SEPSIS:
Some of the signs and symptoms of organ dysfunction that may indicate that a person has severe sepsis may be:

 

  • Difficulty breathing
  • Significantly decreased urine output
  • Abnormal heart function
  • Areas of mottled skin
  • Decrease in platelet count
  • Abrupt change in mental status


In addition to the signs and symptoms of sepsis, if someone exhibits at least one of the symptoms mentioned above, their diagnosis will be upgraded to severe sepsis.


SEPTIC SHOCK:
In case someone experiences the signs and symptoms of severe sepsis, in addition to extremely low blood pressure, they will be diagnosed with septic shock.
In people who are hospitalized, sepsis occurs more frequently. People who are especially vulnerable to developing infections that can lead to sepsis are those in the intensive care unit (ICU). A person should seek immediate medical care in case they get an infection, or if they develop signs and symptoms of sepsis after surgery, hospitalization or an infection.

Causes:

One of the weapons that the immune system uses to fight infection is inflammation. Normally, the inflammatory process starts and stops by a delicate balance of chemical signals. However, this process becomes exaggerated in sepsis, and the inflammation extends beyond the infection site and affects the whole body.
The formation of microscopic clots in tiny blood vessels throughout the body will be prompted by the widespread inflammation. Also, the overactive inflammatory response will interfere at the same time with the body's natural ability to break down blood clots. This will cause the heart to work harder to pump blood; however, the organs will fail because the clots will prevent enough oxygen from reaching them.

Anyone with an infection could develop sepsis, but some of the factors that may increase this risk include:

Age: Infants and people over the age of 65 are more susceptible to developing sepsis.


Race: Black people are more likely to develop sepsis, especially men.


Compromised immune system: In case someone’s immune system has been weakened due to kidney or liver failure, cancer or cancer treatment, anti-rejection drugs that are taken after organ transplants or HIV or AIDS, their risk of developing sepsis will increase.


Hospitalization: Hospitalized people have an increased risk of developing sepsis, especially those at intensive care units.
Invasive medical devices: In case a person has a breathing tube, a urinary catheter or artificial joints, their risk of getting sepsis will be increased.

Medical conditions: If someone has pneumonia, diabetes, severe injuries such as large burns or bullet wounds, or if they have bacteremia, which is a bacterial infection in the blood, their risk of getting sepsis will be higher.
Genetics: It seems that some people have a genetic tendency toward developing sepsis.

Complications

Complications:

Sepsis could be either mild or severe. Blood flow to the brain, heart and kidneys may become impaired in case sepsis worsens. Various degrees of organ failure and tissue death (gangrene) could also occur in case sepsis causes blood clots to form in someone’s organs and in their legs, arms, toes and fingers.

Even though about 15% of people with mild sepsis die, the rest usually recover. It has been estimated that the mortality rate for severe sepsis or septic shock is about 50%.

Treatments:

Someone’s chances of surviving sepsis are improved by early and aggressive treatment. Severe sepsis requires close monitoring, as well as treatment in a hospital intensive care unit. In case someone has severe sepsis or septic shock, in order to stabilize their breathing and heart function, lifesaving measures may be needed.

THERAPY:
Usually, people with severe sepsis receive supportive care, which include oxygen and intravenous fluids. Depending on someone’s particular condition, they may need dialysis for kidney failure or a machine to help them breathe.

MEDICATIONS:
Sepsis may be treated with some of these medications:

Vasopressors:
Vasopressor medications constrict blood vessels and help to increase blood pressure. The patient may be given a vasopressor medication in case their blood pressure remains too low even after they receive intravenous fluids.

Antibiotics:
Before the infectious agent is identified, treatment with antibiotics should begin. At first, the patient will receive broad-spectrum antibiotics, which are affective against a variety of bacteria. These should be administered intravenously. The antibiotic may be switched to a different one which is more appropriate against the particular bacteria causing the infection, after the results of the patient’s blood test has been checked.

Other medications:
The patient may also receive painkillers, sedatives, drugs that modify the immune system responses, low doses of corticosteroids or insulin to help maintain stable blood sugar levels.

SURGERY:
In case drainage tubes, medical devices, collections of pus (abscesses) or intravenous lines are the sources of the infection, they may need to be surgically removed.

Prognosis:

Not Available

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