What is sepsis? Know the signs of this life-threatening medical emergency

When an infection develops, the body’s immune system gets to work fighting it. 

But sometimes, that response can spiral out of control. Instead of targeting the infection alone, the body begins damaging its own tissues and organs, leading to a potentially life-threatening condition known as sepsis.

Sepsis is a medical emergency that can progress quickly, making it important to recognize the warning signs and seek prompt treatment. During Sepsis Awareness Month, Gul Madison, MD, infectious disease specialist at Trinity Health Mid-Atlantic Medical Group’s Infectious Disease Darby, explains what causes sepsis, who may be at risk and what symptoms should never be ignored.

What causes sepsis?

While viral infections can lead to sepsis, bacterial infections are the most common causes, particularly:

• Urinary tract infections
• Pneumonia
• Skin and soft tissue infections
• Gastrointestinal infections

According to the CDC, approximately 1.7 million adults and 18,000 children in the U.S. develop sepsis each year. At least 1 in 5 adults and 1 in 10 children who develop sepsis die during hospitalization or are discharged to hospice.

“These cases occur when the body’s response to infection becomes uncontrolled and starts affecting the body in harmful ways,” says Dr. Madison. “The blood vessels can become leaky or lose their ability to maintain blood pressure, blood flow to tissues can become abnormal and the body’s ability to use oxygen can be impaired. As a result, important organs such as the kidneys, lungs, brain and heart may stop working properly.”

Who is prone to develop sepsis?

Anyone can develop sepsis, including previously healthy people. However, certain groups are at higher risk:

• Elderly
• Newborn infants
• Cancer patients
• Organ transplant recipients
• Those on steroids or other immunosuppressive drugs
• Those with chronic illnesses, such as diabetes, lung disease or kidney disease
• Recently hospitalized patients

What are the signs of sepsis?

Most cases of sepsis begin outside of a health care setting. Due to its life-threatening nature, it’s important to know when to seek emergency medical attention.

According to Dr. Madison, early symptoms of sepsis are oftentimes subtle and may include:

• Elevation in body temperature
• Increased heart and respiratory rate
• Worsening signs of the infection 

The more obvious signs that warrant an immediate 9-1-1 call and prompt evaluation are:

• Confusion
• Difficulty staying awake
• Very little or no urine
• Cold and clammy skin
• Very fast heart rate while feeling extremely ill
• Difficulty breathing

“But you don’t need to wait until all these symptoms are present to seek care, as sepsis is a medical emergency,” says Dr. Madison. “Early recognition is crucial because sepsis can progress very rapidly within hours. Early administration of antibiotics can save lives.”

What does sepsis treatment involve?

As soon as a patient enters the emergency department, their vitals are checked and labs are drawn up. If sepsis is suspected or confirmed, the source of the infection is determined and treatment begins immediately.

This may involve the administration of IV fluids to support circulation, intubation if there’s respiratory failure or medication for low blood pressure. For control of the infection, patients may need procedures such as drainage of an abscess, or treatment of an infected obstruction in the urinary or gastrointestinal tract.

Do sepsis patients recover?

Recovery from sepsis looks different for each patient, depending on the severity and which organs were involved. Many recover completely, though it can take weeks or months.

For some patients, however, sepsis can cause long lasting physical, cognitive and emotional symptoms:

• Fatigue and weakness
• Muscle loss
• Sleep disturbance
• Anxiety
• Depression
• PTSD-type symptoms
• Reduced kidney function
• Lung damage
• Blood clots
• Secondary infections
• Prolonged hospital admission
• Overall deconditioning, especially for the elderly and immuno-compromised 

How can I lower my risk of developing sepsis?

The main line of defense against sepsis is practicing infection prevention. This can be achieved by staying up to date on recommended vaccinations, following hand hygiene and managing chronic conditions.

However, even the best preventative steps are never 100 percent foolproof, which is why being aware of sepsis and its symptoms could be lifesaving.

“The most important message is that sepsis is a medical emergency,” says Dr. Madison. “If someone has an infection and it is getting worse, particularly if they are confused, having difficulty breathing, extremely weak, clammy or otherwise appearing very ill, they should seek immediate medical attention.”

Visit Infectious Disease Darby for more information on infection disease control and to make an appointment.