What is sepsis (blood poisoning)?

Blood poisoning (medical term: 'sepsis') is a very serious disease, sometimes resulting in death. It is caused by an infection, usually bacterial. This article gives insights into what sepsis is by studying the symptoms, the people at risk, the diagnosis and the treatment of the disease.

Sepsis (blood poisoning): general information

As was already mentioned in the introduction, sepsis is caused by an infection usually due to bacteria or bacterial products (toxins). Not the infection, but the patient's body itself will lead to blood poisoning. That is why sepsis is often described as a systematic inflammatory response by the patient's body caused by the infection. The infection can only enter the circulation through an open connection between the circulation and the 'outside world' or through an organ that is exposed to the 'outside world'. This can be a wound (usually an inflamed wound) or an infection of an organ (for example with pneumonia, cystitis or skin infection).

Sepsis can usually be recognized by three main symptoms: low blood pressure, fever and an increased pulse. These three symptoms together are called 'warm shock'. With sepsis there is also usually a decreased organ blood flow, which compromises the distribution and uptake of oxygen throughout the whole body. This shortage of oxygen can seriously damage organs and even lead to organ failure. When multiple organs are damaged by this oxygen deficiency, this is called Multiple Organ Dysfunction Syndrome (MODS).

The damage to the organs can be temporary. This is mainly the case when the sepsis is diagnosed in time and the flow of oxygen can be restored immediately. The damage to the organs can also be permanent. This is the case when sepsis is not diagnosed in time and the organs have been denied oxygen for too long. This will shut down the organs, which may in some cases lead to death.

Who are at risk for sepsis?

Sepsis is a disease that can occur in men and women of every age and every skin colour. Like with other diseases, young children, elderly people and people with an impaired immune system (for example due to co-morbidities) are more at risk for sepsis. Therefore, in these groups, people more often die as a result of sepsis. A common type of sepsis is meningococcal sepsis. This bacterium (meningococcal) is also the bacterium that causes meningitis. 

Signs and symptoms of sepsis

Common symptoms of sepsis are high fever, tachycardia, tachypnea, cold chills, hypotension and confusion. Other signs of sepsis are decreased urine production, gradually increasing skin haemorrhage (petechiae and purpura), oedema (abnormal accumulation of fluid) and disseminated intravascular coagulation. Tachycardia simply means a higher pulse and tachypnea means an increased breathing frequency. Hypotension means decreased blood pressure. 

Diagnosing sepsis

A doctor can diagnose sepsis using a blood test. During the blood test the blood is examined using a microscope and, in patients with sepsis, bacteria or other micro organisms that should not be present will be found in the blood. Sepsis can also be diagnosed by examining sterile body fluids, such as urine.

Increased risk

There are some groups of people with an increased risk of sepsis, namely: cancer patients (predominantly cancer patients treated with chemotherapy), elderly, children (under the age of 4), patients that have recently had surgery and patients with a weak immune system (for example, people with AIDS or people using drugs that suppress the immune system).

Treatment of sepsis

When sepsis is diagnosed, treatment has to be initiated as soon as possible. Usually, the treatment of sepsis is performed at the intensive care unit of a hospital and comprises multiple interventions. First, the patient will be treated with antibiotics. Administering antibiotics is done to kill the bacteria causing the sepsis. Furthermore, large amounts of fluids will be administered into the body to sustain the blood flow to the organs. Drugs to increase the blood flow can also be administered. This will increase the blood flow trough the body and thus increase the amount of oxygen that reaches the organs and tissues and decreases the chance of loss of organs. A few patients with sepsis will need surgery to remove the inflammation site (for example a large wound or an inflamed organ).

Mortality rate

Even in countries with a modern medical health system such as the Netherlands and Belgium, 30 to 40 percent of the patients suffering from sepsis die due to this disease.

Sources: www.todio.nl