Sepsis is a condition where an infection triggers your immune system to react. This can often lead to inflammation all over your body, leading to symptoms such as chills, fever, skin rash and low blood pressure. Sepsis can have very adverse effects, including organ failure and death as well. Therefore, it is of utmost importance that sepsis must be treated at once.

According to the National Institute of General Medical Sciences, about 1.7 million adults in the US develop sepsis, in a year. Out of these, 270,000 cases lead to death.

What is sepsis?

When we fall sick, our immune system often works overtime to fight off the infection. However, at times, it starts to fight off our tissues and organs and stops fighting the infection. “Sepsis is a life-threatening condition that occurs when the body's response to an infection causes injury to its own tissues and organs. It happens when the immune system, which typically helps fight infections, goes into overdrive. This can lead to shock, multiple organ failure, and even death if not identified early and treated promptly,” says Emergency Medicine expert Dr Kushal Pandya.

Blood clots can be formed in our blood vessels, as a result of sepsis, and this can hinder the blood flow to different areas and organs of the body. This can lead to organ failure and even death.

What are the stages of sepsis?

There are three stages of sepsis:

1. Sepsis

Here the infection enters your bloodstream and starts to cause inflammation. This is the first stage, and treatment must be sought at once.

2. Severe sepsis

This is the second stage of sepsis and can be very dangerous. Here, the inflammation as well as the infection gets quite severe and starts to damage the organs as well.

3. Septic shock

This is the last and most serious stage of sepsis. In this stage, blood pressure can drop significantly, which can lead to heart failure or respiratory failure. Besides this, it can lead to organ failure, and death as well.

Symptoms of sepsis

Sepsis is a medical emergency and can present various signs and symptoms at different times. Immediate medical attention is crucial. Common signs and symptoms include:

• Fever or low body temperature with shivering
• Confusion
• Difficulty breathing
• Clammy and sweaty skin
• Extreme body pain or discomfort
• High heart rate, weak pulse, or low blood pressure
• Low urine output

In children, signs of sepsis may include:

• Fast breathing
• Convulsions
• Pale skin
• Lethargy
• Difficulty waking up
• Feeling cold to the touch

For children under 5 years old, symptoms might include difficulty feeding, frequent vomiting, or lack of urination.

Sepsis is a very serious condition that requires immediate hospitalization. Image courtesy: Adobe Stock

Causes of sepsis

The World Health Organization (WHO) states that sepsis is caused by bacterial infections most of the time. However, viruses, parasites and even fungi can bring your body into a state of sepsis. Sepsis is one of the most common hospital acquired infections as well.

Therefore, these conditions can cause sepsis:

• Pneumonia
• Infections in the abdomen
• Kidney infections
• Blood poisoning
• Urinary tract infections, especially if you have a catheter
• Appendicitis, or an infection of your appendix
• Gallbladder infection
• Infections to your brain or spinal cord
• Wounds or inflammation on the skin
• Cellulitis

Who is most at risk to get sepsis?

While anyone with an infection, severe injury, or serious non-communicable disease can develop sepsis, certain populations are more vulnerable. According to the Centres for Disease Control and Prevention (CDC), these people include those who are:

• Older adults
• Pregnant or recently pregnant women
• Neonates
• Hospitalized patients
• Patients in intensive care units
• Individuals with weakened immune systems (e.g., HIV, cancer)
• People with chronic medical conditions (e.g., kidney disease, cirrhosis)

Sepsis in babies

Sepsis can happen to babies, and infants under one year are most at risk. If the infant experiences a blood infection in the first month of his life, she is at risk of sepsis. It depends on when the baby caught the infection, during or before birth, or after she was born. This will decide the course of the treatment as well. Premature babies and babies with low birth weight are most at risk. Some of the symptoms that they might showcase include not breastfeeding, low body temperature, listlessness, pale colour, fever, vomiting, diarrhoea, breathing difficulties and seizures.

Sepsis in older people

Be it a weakened immune system due to age, or other chronic diseases such as diabetes, kidney disease or other underlying conditions, the older generation is most at risk for sepsis. Confusion is one of the symptoms of sepsis, and this might be masked if a person is already suffering from dementia. Other causes include malnutrition or an imbalance in intestinal microbiota.

Diagnosis of sepsis

Early diagnosis of sepsis is of utmost importance, and hence, it must be taken very seriously. The doctor will perform a series of tests after assessing your symptoms to understand if you have sepsis or not. These tests include tests to check blood pressure, a Systolic reading of less than 100 mmHg should trigger an alarm. Besides this, the doctor will check your respiratory rate; If you have more than 22 breaths per minute, that can be dangerous as well. The Glasgow Coma Scale will also be analysed. This is a tool to see your decrease in consciousness. If you score less than 15, then it can be dangerous.

Also, your body temperature will be checked. If you have a fever of more than 100.4°F (38°C) or less than 96.8°F (36°C), then it can be alarming.

Besides this, the patient will undergo routine blood cultures and tests such as complete blood count or CBC, blood oxygen levels, urine tests and cultures, as well as X-rays and CT scans.

Sepsis can happen in kids and infants as well. Image courtesy: Adobe Stock

Treatment of sepsis

Sepsis requires immediate hospital treatment as it can worsen rapidly. Antibiotics should be administered within one hour of hospital arrival. Without prompt treatment, sepsis can progress to septic shock and cause organ failure, which is life-threatening. Depending on symptoms, additional treatments may include:

• Intensive care unit admission
• Ventilator support
• Surgery to remove infection sites

Patients may need to stay in the hospital for several weeks.

Recovery from sepsis

Recovery from sepsis can take a long time, even after you are discharged from the hospital. The UK Sepsis Trust states that 40 per cent of people who are diagnosed with sepsis, face physical, cognitive and psychological aftereffects. You might experience the following symptoms:

• Joint and muscle pains
• Lethargy
• Insomnia
• Swollen limbs
• Poor appetite
• Vision problems
• Excessive sweating
• Mental health problems may include
• Depression
• Nightmares
• Mood swings
• Memory loss

The CDC states that there are some steps that you can take to feel better. You can eat a balanced diet, work as much as you can comfortably manage and make sure to rest and rebuild your strength. You may also maintain a journal, to fill in for memory loss.

How to prevent sepsis?

Yes, the chances of catching sepsis can be lowered if some changes are made in your lifestyle. Preventing sepsis involves early treatment of infections and maintaining good hygiene both at home and in healthcare settings. Key steps include:

•  Practicing good personal hygiene, such as hand washing and safe food preparation
• Avoiding unclean water or unsanitary toilets
• Getting recommended vaccines
• Eating a healthy diet
• Breastfeeding newborns

Healthcare facilities should adhere to effective infection prevention and control protocols, and antibiotics should be used appropriately to treat infections. While sepsis is always serious, individuals with conditions like HIV, tuberculosis, malaria, and other infectious diseases are at higher risk.

Summary

Sepsis is a life-threatening condition that can progress rather quickly. Therefore, it is very important to get medical help as soon as possible. Sepsis happens when our body’s immune system stops fighting the infection and starts to damage organs and tissues. Chills, fever, low blood pressure, and confusion are all symptoms of sepsis. However, sepsis is not contagious.

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