Sepsis, which is also referred to as “blood poisoning”, is a dangerous condition. It means that bacteria got into the bloodstream and they can spread all over the body with the blood. In addition, the body may react with a very strong defensive reaction, which can be even more harmful than the bacteria.


The cause of a sepsis is bacterial infection that began to spread uncontrollably. Theoretically, it can be caused by every bacterium. The most common sources of septic condition are urinary tract infections and pneumonias. The risk factors are high age and weakened immunity (patients with diabetes, AIDS, etc.).


The septic symptoms usually include high fever, general malaise, fatigue, accelerated heart rate and respiratory rate. Other possible symptoms occur due to damage of various organs by the infectious process (cough and shortness of breath in pneumonia, back pain in pyelonephritis, etc.). The sepsis usually affects the motility of our digestive tract causing nausea and vomiting.


The most feared complication of sepsis is known as the septic shock. This is a condition when both the infection and immune response of our body cause expansion of blood vessels, which is followed by a significant decrease of blood pressure. The heart responds by further acceleration of the heart rate to maintain the blood flow. However, this is not enough and the circulatory system fails. Inadequate supply of oxygen disrupts the internal environment and the situation may even result in failure of proper blood clotting. The disrupted blood clotting may cause both the occurrence of blood clots in tiny vessels and uncontrolled bleeding. Patients in such condition usually die without urgent therapy, but the mortality is high even with maximal medical care. The classic example is a sepsis caused by the meningococcal infection.


Note: A good orientation in the severity of the actual condition means repeated measurement of the patient’s blood pressure and pulse. If the systolic pressure (in mm Hg) is lower than the heart rate (in beats per minute), the situation is really serious.


The sepsis has several diagnostic criteria including heart rate above 90 bpm, accelerated respiratory rate (above 20 breaths per minute), elevated body temperature, elevated number of white blood cells, etc. If there is a suspicion of sepsis, it is necessary to obtain the blood cultures, i.e. samples of blood for microbiological examination. This examination should determine the presence of bacteria, their type and actual sensitivity to antibiotics.


The therapy depends on the severity of condition. Antibiotics are the methods of the first choice. We use broad-spectrum antibiotics in adequate doses and the preferred administration is intravenous. The supportive therapy is needed as well, the patient must be hydrated and we have to prevent the emergence of shock. Severe cases including the septic shock must be treated in an ICU department with continuous monitoring of basic vital functions and protecting the cardiovascular system from failure (including the administration of epinephrine or norepinephrine to maintain the adequate blood pressure).


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources