Sepsis: Signs, Symptoms, Causes, and Treatment

Sepsis refers to the development of a system-wide illness that causes a cascade of health problems throughout the body. If not recognised and treated promptly, sepsis can cause rapid deterioration and death. Understanding the signs and symptoms and taking prompt action helps save lives.

According to the Centers for Disease Control and Prevention, over 1.5 million Americans develop sepsis yearly. And of those, almost a third will die. Sadly, over the past thirty years, the number of people developing sepsis has increased and continues to rise.

Healthcare costs for treating sepsis far outnumber that of treating patients with heart failure or heart attacks. This cost accounts for the acute hospitalization stage and the post-sepsis chronic complications and disabilities. So, seeing sepsis’s early warning signals and getting help right away can reduce illness and medical expenses while saving lives.

Sepsis, a life-threatening illness, what you need to know

Sepsis is a life-threatening illness secondary to an infectious agent. When the body is fighting infection and has an overwhelming reaction to this illness, it can lead to organisms such as bacteria, fungi, or virus particles and immense inflammation traveling through the bloodstream to organs far from the site of the original infection. Ultimately, devastating damage occurs throughout the body, and organs fail to receive adequate blood supply and nutrients necessary for life.

Normally, our immune system works to defend against invaders, and various organisms causing illnesses from the common cold to COVID-19, wound infections, and much more. Multiple cells, proteins, and organs, even our GI tract, participate in our body’s immune response. Under normal conditions, our body’s immune system functions to resolve infection just enough to kill an organism but not enough to damage our cells and organs.

In the case of sepsis, however, the immune system damages tissues and cells within the body. The inflammatory cascade spins out of control, further increasing injury to cells and organs. This vicious self-damaging cycle causes organ damage or failure, blood clots, leaky blood vessels, decreased oxygen delivery, and death. Once started, this injury cycle is very difficult to treat and control.

Signs and symptoms of sepsis

Almost any condition could lead to sepsis. Sepsis signs and symptoms may be subtle, especially in the early stages, and could encompass several of the following:

Severe sepsis occurs when, in addition to the above possible signs/symptoms, a person develops evidence of organ dysfunction. Signs consistent with liver dysfunction, decreased urine output/production (kidney disease), change in mental status (brain effects), or breathing problems (lung pathology).

Regardless of the myriad of signs a person demonstrates, hospitalization, sometimes even intensive care (in the ICU) is necessary for sepsis treatment. Thus, prompt recognition that sepsis is occurring is critical.

When is it T-I-M-E to get help?

The Sepsis Alliance recommends remembering It’s About Time to seek help if you are displaying any combination of symptoms related to

• Temperature (too high or low).
  
• Infection (known or suspected infection and related signs like redness, warmth, discharge, and pain).
• Mental decline (sleepy, confused, hard to engage).
• Extremely ill (trouble breathing, horrible pain).

Causes of sepsis

Sepsis doesn’t just magically appear out of thin air. Something must trigger the massive cascade of inflammatory cells and the colossal system-wide infection.

Sepsis can be triggered by any infection. Causes include: parasites, bacteria, fungi, and viruses.. Most commonly , sepsis occurs secondary to pneumonia, urinary tract infections, GI tract illnesses, and even simple wounds. So, even mild ailments can trigger this potentially fatal disease.

Who’s at risk of sepsis?

Technically, anyone can develop sepsis. It is impossible to predict whose body will respond in an extreme way to an infection or severe trauma. However, those at an increased risk of sepsis include:

• Infants and kids under one.
• Older adults (65+).
• Those with chronic illnesses, e.g., diabetes or heart disease.
• The Immunosuppressed, e.g., those with cancer, those on immunosuppressive drugs, those with AIDs.
• Malnourishment (inappropriate or insufficient nutrition).
• Anyone who had sepsis previously.
• Those recently hospitalized with significant illness or recent surgery.

Many people falsely assume that sepsis only occurs in people already in the hospital. This leads many people to wait too long to seek the critical care they need, even for minor scrapes and cuts. However, most sepsis cases start outside the hospital setting. According to the Centers for Disease Control and Prevention, over 85% of septic patients develop the condition before arriving at a hospital.

Be proactive if you suspect sepsis

Hours count! If you have a combination of symptoms suggestive of worsening illness or infection, a known wound, or had a recent viral or another type of disease, then contact your health care provider asap.

What should I do when I think I may have it?

Sepsis requires intensive therapy, medications, monitoring, and hospitalization. The best thing you can do for yourself or a loved one when you suspect sepsis is to get them medical care urgently!

Call the ambulance or drive them to the ER yourself. Do not wait. But call ahead! Call your doctor or the emergency room ahead of time and let them know you are concerned about sepsis. Sure, a minor wound can wait in the ER for hours without ill effects. Still, those with sepsis need to be evaluated and treated immediately.

Treating sepsis

Therapy for sepsis includes intensive hospitalization and care. Treatment of the underlying infection includes key staples in sepsis therapy.

• Appropriate injectable medications (antimicrobials, and medications to support nausea, vomiting, or other signs and symptoms that develop from sepsis).
• Fluid therapy to maintain hydration.
• Maintain proper nutrition (feeding via feeding tubes or veins when needed).

Additional treatments include blood pressure support and organ-specific needs. Those with kidney damage may require dialysis, while those with lung disease may require oxygen therapy or a ventilator to breathe.

Sepsis has no specific cure, and researchers are still investigating exactly how the sepsis process damages the body. While there is no cure for sepsis, we can address any infection triggering the response. Hopefully, in time, the findings will permit the development of a medication to treat the inflammatory processes that lead to sepsis directly. Until that time, supportive care and antimicrobials (medicines aimed at the underlying infectious cause of the system-wide illness) are all we have in our therapeutic arsenal.

Sepsis recovery

How hard is it to recover from sepsis?

Sepsis recovery can be challenging and can take weeks to months. Many patients require intensive rehabilitation after sepsis treatment. Patients often need assistance in regaining normal function and performing tasks of daily living, like dressing, brushing teeth, and related activities.

Physical therapy may be necessary during recovery. Even though the inflammation and infection may have resolved, patients, even once home, often suffer from fatigue, weakness, sleep abnormalities, skin changes, and more.

Making sure to eat a balanced diet while recovering, exercising when ready to do so safely, and resting when your body needs it are all keys to a successful recovery.

Long-term consequences post sepsis

According to the Sepsis Alliance, physical and psychological lingering effects may occur after sepsis has resolved. These effects may develop due to loss of blood flow and nutrients to individual organs and other related factors, but why some ill effects develop isn’t well understood. Sadly, we cannot predict who will have post-sepsis impacts and who will not.

Despite recovery from sepsis, patients may experience

Sepsis prevention

Sometimes, no matter what steps we take, we cannot prevent sepsis. However, you can improve your chances by decreasing your risks of infection and getting help as soon as possible. Additionally, always

• Prevent infections.
• Ensure proper hygiene – Hand washing and appropriate wound care (even a paper cut can trigger sepsis).
• Stay current with vaccinations.
• If you have signs of infection, even if seemingly insignificant, seek medical care.
• Recognize signs of infection and sepsis.
• Act Fast.

Understanding sepsis

It is critical to understand sepsis causes, signs, and symptoms. Sepsis can lead to septic shock, with death occurring within hours of onset. Early recognition of this disease saves lives.

If you have an underlying disease or infection and show signs suggestive of sepsis, do not wait. Seek emergency care! Each hour you delay getting care increases the risk of dying. So, hours, even minutes, may make the difference between life and death.