As an inpatient doctor at Rutland Regional Medical Center, I see hundreds of cases of sepsis annually, but many patients and families have trouble understanding the condition. In honor of Sepsis Awareness Month, I felt it would be appropriate to answer the most common questions I receive regarding sepsis to help better understand the diagnosis.
What is sepsis?
Broadly speaking, sepsis occurs when an infection overwhelms the body’s defenses, resulting in organ injury. Infections, which are caused by bacteria, viruses and fungi, are normally contained by the body’s immune system. When the body first detects an infection, the white blood cells, which are the cells in our blood that fight infections, release chemical signals which raise our temperature, increase blood flow, call for more white blood cells, release antibodies and destroy the infection particles, or pathogens. This response normally causes low-grade fevers (under 103°F in adults), redness, swelling and pain. In sepsis, this response is not enough to control the infection, which can spread, leading to organ injury. This can cause symptoms such as low oxygen levels, fast heart rates, very high fevers, low blood pressure, low urine output, confusion and disorientation. If untreated, this may lead to organ failure, shock and, in some cases, death.
How can I lower my risk of getting sepsis?
In most people with healthy immune systems, the risk of sepsis is low. However, in the very old, the very young or those with chronic illnesses or impaired immune systems, the risk is significantly higher. The most important thing that we can all do to prevent sepsis is to live a healthy lifestyle, free from drugs, excessive alcohol, smoking and high-sugar foods. We should also exercise regularly, get a good night’s sleep and stay up-to-date on all recommended vaccinations, especially those for the flu and pneumonia. Practicing good hand hygiene with either soap and water or alcohol-based hand sanitizer, especially while in the community, can help further reduce your risk of contracting an infection. While anyone can still develop sepsis, these activities will significantly reduce your risk and may save your life.
What symptoms should I be concerned about?
The most common infections which cause sepsis in our community are pneumonia (both viral, such as influenza, and bacterial), urinary tract infections, skin infections, blood stream infections, abdominal infections and tick infections. While the causes of these infections are different, the symptoms of sepsis are often the same and include very high fevers, uncontrollable shaking chills, confusion or disorientation, extreme lightheadedness that does not fade with time, and inability to breathe. If you or a loved one has these symptoms, it is important to seek medical attention as soon as possible.
How is sepsis treated?
The most critical factor when treating sepsis is to start antibiotics as soon as the condition is identified. A typical evaluation for someone with an infection will include a thorough history and physical exam, vital signs, labs and imaging such as X-rays. Following this evaluation, patients are often treated with intravenous fluids to support his or her blood pressure, and antibiotics to fight the infection. In most cases of sepsis, the initial antibiotics are intravenous and are changed to oral medications when the condition stabilizes. It is very important to take the course of antibiotics to its completion as directed by your physician.
Is sepsis contagious?
Some pathogens that cause sepsis are extremely contagious, such as influenza and bacterial infections of the stool. Regular hand hygiene when caring for people with sepsis is very important and will help minimize the spread of the infection. In some respiratory infections, a mask may be required to further prevent the risk of spread. In most cases, this risk is gone following the completion of the prescribed course of antibiotics. If you have further questions regarding sepsis, www.sepsis.org is an excellent resource for patients and as always, see your physician for questions specific to your personal health.
This week’s Health Talk was written by Dr. Rick Hildebrant, medical director, hospital medicine, Rutland Regional Medical Center.