Sepsis

Sepsis always stems from a local, limited infection. The infection is usually caused by bacteria, but viruses, fungi and parasites can also cause sepsis. Sepsis is also known as blood poisoning, but it has nothing to do with poisoning in the usual sense. Rather, it is a runaway defense response of the body to the infectious agents. Pathogens and inflammatory messengers spread throughout the body and damage vital organs. 

To avoid death, it needs to be treated in hospital as quickly as possible. Sepsis is the third most common cause of death in Germany. In approximately one third of people suffering a sepsis or a septic shock each year the disease is fatal. 

Would you like information about sepsis prevention and early detection? You will find an infographic on this on the website of the Robert Koch Institute.

Information on how to recognize a sepsis and how serious consequences can be prevented is offered by the initiative of the Action League Patient Safety (Aktionsbündnis Patientensicherheit), Deutschland erkennt Sepsis (Germany recognizes sepsis) (in German).

When an infection spreads through the body, there are initially non-specific symptoms that resemble those that occur with a common cold or flu. 

These may include:

• temperature above 38 degrees or body temperature below 36 degrees
• shivering
• accelerated pulse
• generally feeling very ill
• aches

The following warning signs may indicate sepsis:

• sudden disorientation
• low blood pressure: systolic below 100 mmHg
• rapid breathing: over 22 breaths per minute

If at least one of these three indicators is present, you should get medical help immediately. A case of sepsis is always an emergency.

A red streak slowly spreading on the arm also supposedly indicates sepsis. But most patients do not have this symptom. The red streak occurs if a lymph channel is inflamed, for example due to an infected wound. This can cause sepsis, but it does not necessarily do so. 

Sepsis is always caused by an infection. The infection is usually bacterial, but viruses, fungi and parasites can also cause sepsis. As long as the body can keep the infection local, sepsis does not occur. It is only when it breaks through that pathogens and inflammatory messengers flood the entire body. This can cause damage to organs and circulatory collapse.

Any type of infection can cause sepsis: purulent, inflamed wounds to the skin or mosquito bites, inflamed teeth, infected prostheses, pneumonia, meningitis, urinary tract infections, diarrhea, and many other infectious conditions. Sepsis is the final common pathway if the body’s own defense system can no longer hold back the infection.

Sepsis can quickly become life-threatening, but it does not always need to become serious. Doctors differentiate between two phases:

Sepsis

Sepsis is referred to when the inflammatory response to the infectious agents causes damage to the body. Immune cells and inflammatory messengers then attack vital organs and restrict their function. It usually affects the lungs, heart, liver and kidneys. 

Septic shock

Septic shock involves the cardiovascular function collapsing so that the organs no longer receive an adequate supply of blood. Sometimes multiple organs fail. Many patients die from this type of septic shock.

There is no protection against sepsis itself, but infections that can cause sepsis can be prevented. The following general measures help to avoid infections, which reduces the risk of sepsis:

• Hygiene: wash hands regularly and thoroughly.
• Take good care of wounds and inflamed areas of skin. You should not scratch, and you should keep wounds clean and disinfect them.
• Possibly get a medical opinion if infected.
• If your doctor prescribes an antibiotic, take it as prescribed and for the length of time indicated.
• Chronic conditions such as rheumatism and diabetes can weaken the body’s defenses, and they should be treated properly.
• Lead a healthy lifestyle to strengthen your immune system.
• Vaccinations help to avoid certain infectious diseases.

Doctors diagnose sepsis based on the symptoms and the case history. They then take several blood samples to check how the organs are functioning and to provide evidence of possible infectious agents in the blood. 

Sepsis must be treated in hospital, as it is always an emergency. The quicker medical practitioners start treatment, the better the chances of recovery, and the milder the potential damage. 

Before hospital treatment begins, doctors take several blood samples. On the one hand, this enables the pathogens to be identified and suitable drugs to be chosen. On the other, blood values are measured to show whether and which organs are already being damaged. 

Even before the blood test results are in, the patient is given an antibiotic that acts against the most common sepsis pathogens. They are also given intravenous fluids to stabilize the circulation. Once the blood test results are in, doctors can switch to the most effective drug. 

If blood pressure values drop dramatically and there is too little oxygen in the blood, the patient must be treated in intensive care. If it is not clear where the pathogens are coming from, doctors need to do more tests to identify the source of the infection so that they can treat it. 

Patients that have had severe sepsis very often suffer mental and physical complications. Top-class aftercare is not always possible, however, for example due to a lack of rehab places. Organizations like Deutsche Sepsis-Hilfe e.V. offer those affected and their relatives a platform for getting information, finding the help that is available, and for sharing experiences with others who have been affected.

Go to the Deutsche Sepsis-Hilfe e.V. website

There is a World Sepsis Day every year on September 13th. This aims to draw attention to the high rates of illness and fatality, and to help change this through early detection and better treatment methods.