Medically reviewed by Michael Menna, DO
Sepsis is the immune system's extreme response to an infection. Each year 1.7 million adults in the United States get sepsis and almost 270,000 die as a result. It is also the leading cause of death in intensive care. Sepsis is a medical emergency, and if you or someone you know is showing signs or symptoms of it you should seek medical treatment right away.
Common symptoms of sepsis include fever, chills, clammy skin, and shortness of breath. Many of these symptoms are also common with a regular infection, so it may be difficult to tell at the early stages that what you are experiencing is sepsis. These signs may become more intense over time and new symptoms may appear as sepsis progresses.
Later signs of sepsis include confusion, low oxygen levels, and low urine output. These can be signs of extreme inflammation and organ failure that are life-threatening.
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Early symptoms of sepsis can often be similar to those of an existing infection, making them easy to miss at first. Some common early symptoms of sepsis are changes in vital signs, including:
An elevated body temperature of 100.4 degrees or greater
Shivering, chills, or clammy and sweaty skin
Hypothermia, or having a body temperature of 96.8 degrees or less
Tachycardia, or having a heart rate of 90 beats per minute or higher for adults
Tachypnea, or taking 20 or more breaths a minute for adults.
As sepsis progresses it may become classified as severe sepsis, which is defined as sepsis and end-organ dysfunction. This means that the process of sepsis is causing your body's organs to become damaged or shut down. Sepsis at this stage can progress very quickly to the last stage of sepsis, septic shock, and will require treatment in an intensive care unit (ICU).
The lungs are organs that may be affected by severe sepsis. If you have severe sepsis, you may begin breathing very quickly, have difficulty breathing, and develop hypoxia (low blood oxygen levels). Hypoxia can cause cyanosis, which is when someone's lips, fingers, or toes take on a bluish hue.
As the lungs become more stressed, it could lead to acute respiratory distress syndrome (ARDS) and a breathing machine may be required—at least temporarily—to support you.
Sepsis often affects the kidneys as well. Sepsis can cause an acute kidney injury (AKI), in which your body puts out very little urine or stops making urine altogether. This can cause toxins to build up in your blood since your kidneys aren't filtering them out.
Dialysis is sometimes used to support the kidneys. During dialysis, a machine filters your blood for you while your body is healing. Sometimes people will need to be on dialysis even after they have recovered from sepsis. The good news is that AKIs are often reversible and many people regain kidney function, depending on how severe the initial damage was.
The brain is frequently affected by severe sepsis, too. This can begin as confusion or agitation. It can cause you to appear drunk or sleepy. These symptoms can progress, making it hard to wake up or even causing a coma.
Someone who survives sepsis may see many of these symptoms go away; however, sometimes memory or concentration issues can continue.
End Stage Symptoms
The last stage of sepsis is septic shock. Septic shock is very serious, with a mortality rate of up to 40%. Someone with septic shock will have the symptoms of severe sepsis as well as hypotension, or low blood pressure. Septic shock can become fatal when your blood pressure drops too low to be able to get oxygen into your tissues.
There may be a brief period when you are entering septic shock where your body can compensate and keep your blood pressure up. However, it may begin to dip eventually. At this stage, you experience decompensated septic shock, causing arms and legs that are cool to the touch and a "thready" pulse, which is a pulse that is very weak and might feel like a thread under your finger.
When to See a Healthcare Provider
Sepsis is a serious medical emergency, so it is best to err on the side of caution and reach out to a healthcare provider if you are concerned. If you or a loved one has an infection that has not gotten better or has gotten worse, seek medical help, whether or not you think it has progressed to sepsis or not. If you are exhibiting any of the symptoms listed above for sepsis, ask your healthcare provider if you need to go to the emergency room or not.
A Quick Review
Sepsis is a medical emergency that requires immediate medical attention. Common signs and symptoms include fever, hypothermia, fast heart rate or breathing, confusion, chills, and sweaty or clammy skin.
Sepsis can progress to organ failure and septic shock, which causes dangerously low blood pressure. Sepsis can be treated, but will almost definitely require a stay at the hospital and often in the intensive care unit for advanced cases.
Frequently Asked Questions
What is a common trigger of sepsis?
The most common trigger for sepsis is a bacterial infection. Some fungal infections, or viral infections like the flu or COVID-19, may also trigger it.
What happens right before sepsis?
Right before sepsis you will have an infection that triggers a chain reaction through your body that becomes sepsis. Why this happens still isn't well understood.
Can sepsis be stopped if caught early?
Yes, sepsis can be treated if caught early and people can survive even when it progresses to septic shock, although prognosis tend to be better the earlier treatment is started.
What can sepsis be mistaken for?
Sepsis can sometimes be mistaken for drug toxicity, adrenal crisis, cardiogenic shock, hemorrhagic shock, as well as several other conditions. This is why it is important to see a healthcare provider if you are worried about sepsis. Be sure to tell them if you have an infection or think you have an infection.
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