(Sepsis, Septicemia)
Definition
Blood poisoning is an illness due to an infectious agent or its toxin spreading through the bloodstream. The presence of bacteria in the blood is called bacteremia.
Short bursts of low levels of bacteria in the blood usually do not cause problems. For example, mild bacteremia typically occurs during a dental cleaning or when brushing your teeth. Your body's immune system fights off these bacteria.
If bacteria persist in the blood, however, they may cause sepsis, a serious, life-threatening condition.
Causes
Sepsis occurs when large numbers of infectious agents persist in the bloodstream. Most commonly, bacteria enter the blood from an infection somewhere in the body or on its surface. Infections with fungi and other parasites may lead to sepsis as well. The initial infection could be from any source, but often comes from:
• A burn, ulcer, or other open wound
• Pneumonia
• Urinary tract infection
Less commonly, bacteria may enter the bloodstream directly from an outside source, such as a dirty needle used by an intravenous (IV) drug user. In some cases, the source of the infection is unknown.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
• Recent illness or hospital care
• Frail health due to extreme age
• Poorly functioning immune system due to:
o Cancer or chemotherapy for treatment of cancer
o Diabetes
o AIDS or another immunosuppressive condition such as an autoimmune disease or an immune deficiency
o Immunosuppressive medications needed after a transplant
• Medical treatment with an invasive device
• IV drug abuse
Symptoms
Initial symptoms depend on the site of the infection. For example, with pneumonia you would have a cough and shortness of breath. With a urinary tract infection, you would have frequent urination and a burning sensation.
As the condition progresses to sepsis, symptoms include:
• Fever and chills
• Low temperature
• Paleness of skin color
• Listlessness
• Changes in mental status
• Rapid breathing
• Increased heart rate
• Decreased urine output
• Low blood pressure
• Shock
• Problems with bleeding or clotting
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. If sepsis is suspected, the doctor will try to find the source of the infection.
Tests include:
• Several blood cultures to confirm the diagnosis of sepsis
• Urine and other blood tests to check for signs of infection
• Cultures of urine, sputum, stool, and other secretions to check for bacteria or other infectious agents
• X-ray–a test that uses radiation to take a picture of structures inside the body
• CT Scan–a type of x-ray that uses a computer to make pictures of structures inside of the body
• MRI Scan–a test that uses magnetic waves to make pictures of structures inside of the body
• Other specialized tests depending on the source of the infection
Treatment
Sepsis requires aggressive treatment. Treatment is directed at the cause of the initial infection, if this is identified.
Early treatment improves the chance of survival. Life-saving measures may be needed to stabilize breathing and heart function. Patients usually require monitoring in an intensive care unit.
Medication
You will be given intravenous antibiotics to fight the initial infection and to clear the infectious agent out of your blood. You will be prescribed oral antibiotics to take after leaving the hospital.
Surgery
In addition to antibiotics, surgery is sometimes required to remove or drain the initial infection.
Supportive Care
You will likely receive other medications, intravenous fluids, and oxygen. Blood transfusions and a respirator (to help you breathe) may be necessary in some cases. Further treatment depends on how your body is responding. For example, you may need kidney dialysis if kidney failure occurs.
Prevention
It is not always possible to prevent blood poisoning. Avoiding IV drug use will eliminate that potential source of sepsis and the possibility of other serious infections (hepatitis and AIDS). Since most cases begin in the hospital, healthcare professionals must take steps to stop the spread of these infections. Getting prompt medical care for infections can reduce your risk of sepsis.
