Sepsis

Sepsis refers to a bacterial infection in the bloodstream or body tissues. This is a very broad term covering the presence of many types of microscopic diseasecausing organisms.

Description

Sepsis is also called bacteremia. Closely related terms include septicemia and septic syndrome. In the general population, the incidence of sepsis is two people in 10,000.

Causes and symptoms

Sepsis can originate anywhere bacteria can gain entry to the body; common sites include the genitourinary tract, the liver and its bile ducts, the gastrointestinal tract, and the lungs. Broken or ulcerated skin can also provide access to bacteria commonly present in the environment. Invasive medical procedures, including dental work, can introduce bacteria or permit it to accumulate. Entry points and equipment left in place for any length of time present a particular risk. Heart valve replacement, catheters, ostomy sites, intravenous (IV) or arterial lines, surgical wounds, or surgical drains are examples. IV drug users are at high risk as well.

People with inefficient immune systems or blood disorders are at particular risk for sepsis and have a higher death rate (up to 60%); in people who have no underlying chronic disease, the death rate is far lower (about 5%). The growing problem of antibiotic resistance has increased the incidence of sepsis, partly because ordinary preventive measures (such as prophylactic antibiotics) are less effective.

The most common symptom of sepsis is fever, often accompanied by chills or shaking, or other flu-like symptoms. A history of any recent invasive procedure or dental work should raise the suspicion of sepsis and medical help should be sought.

Diagnosis

The presence of sepsis is indicated by blood tests showing particularly high or low white blood cell counts. The causative agent is determined by blood culture.

Treatment

Identifying the specific causative agent ultimately determines how sepsis is treated. However, time is of the essence, so a broad-spectrum antibiotic or multiple antibiotics will be administered until blood cultures reveal the culprit and treatment can be made specific to the organism. Intravenous antibiotic therapy is usually necessary and is administered in the hospital.