Sepsis - Septicemia
Septicemia, sometimes referred to as bacteremia, is a syndrome that results from an acute invasion of the bloodstream by certain microorganisms or their toxic products.
Any pathogenic organism can cause septicemia and septic shock. Septic shock is most commonly caused by gram-negative bacteria. Staphylococci, streptococci and other gram-positive organisms are less frequent, as are fungi and certain rare viruses.
Fever, chills, tachycardia (rapid heart beat), and tachypnea (rapid respirations) are common acute symptoms of septicemia. When hypotension (low blood pressure) and signs of inadequate organ perfusion develop, the condition is termed septic shock.
Unfortunately, with the spread of the microorganisms, the tissue injury and the development of organ failure, septic shock has a mortality rate as high as 40 to 60 percent in patients with severe underlying disease (immunosuppression). In patients with no underlying disease, the mortality rate is about 5 percent.
Many organisms that are normal flora on the skin and in the intestines are beneficial and pose no threat. But when they spread throughout the body by way of the bloodstream, they can progress to overwhelming infection unless the body defenses destroy them.
The entry of these organisms can be from another site of infection, a surgical procedure handling infected tissue, an invasive diagnostic procedures, intravenous lines (rarely), urinary catheters, and knife or bullet wounds. Any person with an impaired immunity, the newborn and the elderly are at the greatest risk.
About two-thirds of septic shock cases occur in hospitalized patients, most of whom have underlying diseases. Others at high risk include patients with burns; chronic cardiac, liver or kidney disorders; diabetes mellitus; malnutrition; and excessive antibiotic use.
Most patients have fever and chills, often of abrupt onset. However, some patients may be hypothermic (low temperature). Patients may breathe more rapidly and have changes in mental status (how they think, their alertness, etc.). Hypotension (low blood pressure) is an unfavorable sign.
A medical history, physical examination, and blood tests including blood cultures (to isolate the infectious agent) will be performed.
Reversal of septicemia or septic shock depends upon aggressive treatment of the underlying infection. The treatment will vary according to how severe the septicemia is, the condition of the person, and the severity of the underlying disease.
If possible, the surgical removal or drainage of the source of the infections should be done. Antibiotics should be initiated as soon as the diagnosis is suspected.
The antibiotics and treatment can then be adjusted after the results of diagnostic tests. Intravenous fluids and blood pressure medications may be necessary if hypotension (low blood pressure) or shock develops.
What tests need to be done to diagnose the condition?
What is the cause of the sepsis?
How serious is the condition?
What type of treatment will you be recommending?
Will you be prescribing any medications? What are the side effects?
What is the prognosis?