Sepsis and Septic Shock
What is Sepsis and Septic Shock?
Sepsis is a life-threatening condition that happens when your body's response to infection spirals out of control. Instead of just fighting the infection, your immune system releases chemicals that trigger widespread inflammation throughout your entire body. This inflammation can damage multiple organ systems and lead to tissue damage, organ failure, and death if not treated quickly.
Septic shock is the most severe stage of sepsis. It occurs when sepsis causes dangerously low blood pressure and cellular dysfunction that doesn't respond to fluid treatment. At this stage, the risk of death increases dramatically. Your cells can't get enough oxygen and nutrients, and waste products build up in your blood.
Sepsis can develop from any type of infection, including bacterial, viral, or fungal sources. The condition affects over 1.7 million adults in the United States each year and causes more than 270,000 deaths. Early recognition and treatment are critical because every hour of delay increases the risk of death.
Symptoms
- Fever above 101°F or temperature below 96.8°F
- Rapid heart rate over 90 beats per minute
- Fast breathing rate above 20 breaths per minute
- Confusion or disorientation
- Extreme pain or discomfort
- Clammy or sweaty skin
- Shortness of breath
- Low blood pressure
- Decreased urination
- Discolored or mottled skin
In septic shock, symptoms worsen to include severe drops in blood pressure that don't improve with fluids, altered mental status, and signs of organ failure. Some people may not recognize early sepsis symptoms, especially if they have a weakened immune system or chronic illness.
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Causes and risk factors
Sepsis develops when an infection anywhere in your body triggers an extreme immune response. Common sources include lung infections like pneumonia, urinary tract infections, abdominal infections like appendicitis, and skin infections. Sometimes the original infection site is never found. When bacteria or other germs enter your bloodstream, they release toxins that activate your immune system to release inflammatory chemicals.
Risk factors include being over 65 years old, having a weakened immune system, chronic diseases like diabetes or kidney disease, recent surgery or hospitalization, and invasive medical devices like catheters or breathing tubes. Infants and young children also face higher risk. People who have had sepsis before are more likely to develop it again if they get another serious infection.
How it's diagnosed
Doctors diagnose sepsis by combining clinical symptoms with blood tests and other diagnostic tools. Blood tests are critical for detecting the inflammation and organ dysfunction that define sepsis. Key blood markers include white blood cell count, which can be very high above 12,000 or very low below 4,000 during sepsis. Platelet count often drops because sepsis causes platelets to be consumed or trapped in damaged tissues. Albumin levels typically fall below 2.5 grams per deciliter as sepsis disrupts protein production and causes fluid to leak from blood vessels.
Additional tests include blood cultures to identify the specific germ causing infection, lactate levels to assess tissue oxygen deprivation, and tests of kidney and liver function. Imaging studies like X-rays or CT scans help locate the infection source. Rite Aid offers blood testing that includes white blood cell count, neutrophils, platelet count, and albumin, which are essential markers for detecting and monitoring sepsis risk and inflammation.
Treatment options
- Immediate intravenous antibiotics, usually within the first hour of diagnosis
- Intravenous fluids to maintain blood pressure and organ perfusion
- Vasopressor medications to raise blood pressure if fluids alone don't work
- Oxygen therapy or mechanical ventilation if breathing is impaired
- Source control measures like draining abscesses or removing infected devices
- Close monitoring in an intensive care unit for severe cases
- Treatment of the underlying infection based on culture results
- Supportive care for organ dysfunction, including dialysis if kidneys fail
Prevention focuses on avoiding infections through good hygiene, staying current with vaccinations, proper wound care, and seeking prompt treatment for any infection. People with chronic conditions should work closely with their doctors to manage their health and reduce infection risk.
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- Simple blood draw at your nearest lab
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Frequently asked questions
Sepsis is when infection triggers widespread inflammation that can damage organs. Septic shock is the most severe stage, where blood pressure drops dangerously low and doesn't respond to fluid treatment. Septic shock has a much higher death rate, often exceeding 40 percent. Both require immediate emergency medical care.
Many people survive sepsis, especially when treated early. However, recovery can take weeks to months. Some survivors experience long-term effects called post-sepsis syndrome, including fatigue, muscle weakness, trouble concentrating, and anxiety. The risk of future infections also increases after having sepsis.
Sepsis can develop very rapidly, sometimes within hours of an infection starting. The progression from sepsis to septic shock can happen in just a few hours without treatment. This is why recognizing early warning signs and getting immediate medical care is critical for survival.
Key blood markers include white blood cell counts above 12,000 or below 4,000 cells per microliter. Platelet counts often drop below normal, sometimes falling below 100,000 per microliter. Albumin typically falls below 2.5 grams per deciliter. Elevated lactate levels above 2 millimoles per liter also suggest sepsis.
Yes, some people with sepsis have low body temperature below 96.8 degrees Fahrenheit instead of fever. Elderly patients and those with weakened immune systems are more likely to have hypothermia rather than fever. Other sepsis symptoms like rapid heart rate, confusion, and low blood pressure may be present without fever.
People over 65, infants under one year, those with weakened immune systems, and anyone with chronic diseases like diabetes or cancer face higher risk. Recent surgery, hospitalization, or invasive medical devices also increase risk. People who have had sepsis before are more vulnerable to developing it again.
Sepsis itself is not contagious because it's your body's response to infection, not the infection itself. However, the infections that cause sepsis can sometimes spread between people. Good hygiene practices like handwashing help prevent the infections that can lead to sepsis.
Pneumonia and other lung infections are the leading cause of sepsis, accounting for about half of cases. Urinary tract infections, abdominal infections like appendicitis or diverticulitis, and skin infections are also common triggers. Bloodstream infections from IV lines or catheters can directly cause sepsis.
Septic shock requires more aggressive treatment in an intensive care unit. Patients receive vasopressor medications like norepinephrine to raise blood pressure in addition to antibiotics and fluids. Mechanical ventilation and kidney dialysis may be needed. Treatment focuses on supporting failing organs while fighting the infection.
Regular monitoring of white blood cell count, platelet count, albumin, and neutrophils can reveal inflammation and immune system changes that suggest infection risk. These tests help identify people who may be developing serious infections before sepsis occurs. Early detection of abnormal values allows for prompt evaluation and treatment of infections.