Sepsis is a usually life-threatening infection of the blood with bacteria and their waste products. Bacteria can enter the bloodstream as a result of an inflamed wound or an infection of an organ (such as pneumonia, bladder infection or skin infection). The infection leads to an inflammatory response of the entire body.
Sepsis is caused by the spread of bacteria in the blood. Normally, white blood cells take care of an effective destruction of bacteria when they enter the blood or tissues. This can happen, for example, after an inflammation, such as a boil. When the immune system cannot control an infection in time, the pathogenic bacteria can significantly multiply. Via lymphatic vessels or directly via, for example, damaged blood vessels, they end up anywhere in the body. The ‘poison’ is made up of either the waste products of the bacteria themselves or toxins that are produced by the bacteria.
A common form of sepsis is meningococcal disease, which is caused by the same bacterium that also causes meningitis. This sepsis often develops very quickly, so that the patient may die soon. The bacterium streptococcus pneumoniae can also cause sepsis.
A patient with sepsis is basically not contagious to other people.
Sepsis can be recognized by the following signs and symptoms:
- Rapid heartbeat.
- Blood pressure drop.
- Rapid breathing.
- Cold shivers.
- Decreased urine production.
- Feeling of malaise.
- Initially small, later sometimes expanding bleeding in the skin.
In case of a bacterial lymph vessel infection, a red stripe can sometimes be visible at the skin of the arms or legs. Popularly, this is wrongly referred to as ‘sepsis’. However, if it isn’t treated, the infection can lead to a real sepsis.
The diagnosis of sepsis is based on the symptoms and physical examination. The diagnosis is confirmed by blood tests, microscopic examination or a culture of blood samples. Sometimes, samples of the infected areas are taken or the fluid surrounding the brains and the spinal cord is examined under the microscope. This additional examination is needed, because only this way can be determined which organism has caused the infection and which antibiotic is suitable for treatment.
The patient should be treated as soon as possible. The treatment should in many cases take place in an intensive care unit and always includes several components. Administration of antibiotics to kill bacteria, administration of large amounts of fluid to maintain the blood circulation of the organs and administration of potent medicines to improve blood circulation. Surgery is sometimes needed to remove the inflammation source from the body. Not rarely, a patient should be artificially ventilated, when the lungs are affected or the respiratory power of the patient is insufficient.
Some patients benefit from additional treatments:
- Tube-feeding, by means of a tube that runs through the nose and into the stomach.
- Painkillers and tranquilizers.
- Infusion via a large body vein (for example in the neck or groin), catheters in the bloodstream, urinary catheter.
The prospects often depend on how quickly antibiotics are given after the disease has started. Most people recover well if treated early. Without treatment, most people will die.
Patients who survive a sepsis can keep residual effects. We can think of partial or complete kidney failure, lung function loss and permanent damage from bleeding and necrosis. The latter is, for example, loss of fingers, toes, hand or foot.
- Vaccination for streptococcus pneumoniae is available and is recommended for groups at risk (for example people whose spleen has been removed).
- The major measure to prevent an infection and thus a possible spread, is taking hygienical measures by the nursing staff during surgery or childbirth. Using sterilized surgical instruments is also of great importance.