Overview
Sepsis is a life-threatening reaction to an infection. The body's immune system overreacts and starts to damage the body's own organs. It can follow any infection, most often a bacterial one, and it develops quickly, often over a few hours.
Without early treatment, sepsis can lead to septic shock, a dangerous fall in , then to failure of several organs, and it can be fatal.
Symptoms
Signs can be hard to spot and change over time. In adults and older children, look for:
- Fast breathing, or difficulty breathing
- Confusion or slurred speech
- Uncontrollable shivering
- A very high or very low temperature
- Extreme pain or muscle pain
- Pale, blue, grey or blotchy skin, lips or tongue, or clammy skin
- A fast heartbeat
- Passing very little urine
In babies and young children, also look for a fit, being very sleepy or hard to wake, not feeding, repeated vomiting, and no urine for 12 hours. Sepsis is harder to spot in babies, people with dementia and anyone who cannot easily say how they feel.
When to see a doctor
Do not wait to see whether the signs settle. Anyone who has had sepsis before should tell the doctor early whenever new signs of infection appear.
Causes
Bacterial infections are the most common cause, but viruses such as influenza, fungi and parasites can also trigger sepsis. The infection most often starts in the lungs, the urinary tract, the tummy or the skin.
Why the body overreacts is not fully understood. Infections picked up in hospital, which may resist common , can also lead to sepsis.
Risk factors
- Newborns, babies under one year and older people
- Pregnancy, or having recently given birth or had a miscarriage
- A weak immune system, for example from HIV, cancer treatment or steroid medicines
- Long-term illnesses such as kidney disease or cirrhosis of the liver
- A burn, wound, skin infection or urinary catheter
- A stay in hospital, especially in intensive care
- Heavy alcohol use or injecting drugs
Complications
Sepsis can lead to septic shock, failure of several organs such as the kidneys, lungs and heart, and death.
Recovery can take weeks or months. Post-sepsis syndrome can bring tiredness, poor concentration, low mood, anxiety, and numbness or weakness in the hands and feet, and further infections are more likely for a time.
Prevention
- Wash hands often with soap and water, and prepare food safely
- Use safe drinking water and clean sanitation
- Keep vaccinations up to date, for children and adults
- Have infections, wounds and burns treated early
- Use only when a doctor advises, and finish the course as directed
- Breastfeed newborns
Diagnosis
Doctors check temperature, heart rate, breathing, and alertness, and look for the infection and for signs of organ damage. Tests include blood tests (with blood cultures to find the germ), tests of kidney and liver function, swabs of urine, or wounds, and X-rays or scans to find the source. Treatment starts straight away, without waiting for every result.
Treatment
Sepsis is treated in hospital, and speed matters. are given as soon as possible, often a broad-spectrum one first and then a more specific one. Fluids are given through a vein, oxygen supports breathing, and medicines that raise may be needed.
The source of the infection is dealt with too, sometimes by surgery to remove infected or damaged tissue. Very ill people are cared for in intensive care, where their organs can be supported and watched closely.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Sepsis only happens after surgery, in hospital, or from a serious injury.”What is true?
Fact
Sepsis can follow any infection, including a chest infection, a urine infection, a tummy infection or an infected cut or wound. The CDC notes that most cases begin before the person reaches hospital.
Myth“If there is no high fever, it cannot be sepsis.”What is true?
Fact
Sepsis can cause a very low temperature, and a high temperature is less common in older adults. Look for the other signs too, such as fast breathing, confusion, shivering and passing little urine.
Myth“Only the very old and the very sick get sepsis.”What is true?
Fact
Anyone can get sepsis, including healthy adults and children. The risk is higher in babies, older people, pregnant women and women who have recently given birth, people with weak immunity, and people with wounds, burns or a urinary catheter.
Myth“Once the infection has been treated, life goes back to normal at once.”What is true?
Fact
Recovery can take weeks or months. Some people have post-sepsis syndrome, with tiredness, poor concentration, low mood or anxiety, and numbness in the hands and feet. They may also catch further infections more easily for a time.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
How is sepsis different from an ordinary infection?
In an ordinary infection the body fights the germ in one part of the body. In sepsis the reaction spreads through the whole body and begins to damage organs. That is why sepsis is an emergency, even when it starts from a small infection.
Can a person recover fully from sepsis?
Many people recover, but recovery can take weeks or months. Some are left with lasting problems such as tiredness, memory difficulties or numbness. Early treatment gives the best chance of a good recovery.
Can sepsis happen again?
Yes. Anyone with an infection can develop sepsis, and after an episode the chance of further infections is higher for a time. Get help early if signs of infection return, and tell the doctor that you have had sepsis before.
