Sepsis

Sepsis, or septicemia, is a potentially life-threatening condition caused by a dysregulated immune response to an infection, leading to multiple organ dysfunction. The body’s infection-fighting processes become excessively activated, attacking its own tissues and organs.

As the disease progresses, septic shock may develop, which is a significant drop in blood pressure that results in inadequate blood flow to internal organs. Without the necessary oxygen and nutrients, organs begin to fail. If the damage is severe, it can lead to the patient’s death. In fact, septicemia is one of the most common causes of death worldwide and the leading cause of in-hospital mortality, making early detection crucial. The incidence and fatality rates are extremely high—so much so that sepsis is estimated to cause more deaths than heart attacks, strokes, and breast, colon, rectal, pancreatic, and prostate cancers combined. Furthermore, its significance is increasing as its incidence rises alongside population aging.

Any infection can lead to sepsis, but it is more common in infections affecting the lungs (pulmonary or respiratory sepsis), the digestive system (abdominal sepsis), or the urinary tract (urinary sepsis), as well as infections occurring in wounds, burns, and catheter or IV insertion sites.

Symptoms

Sepsis symptoms worsen progressively as organ damage advances:

• Fever
• Sweating, chills
• Muscle pain
• Increased heart rate and respiratory rate
• Changes in mental state: confusion, disorientation
• Low urine output (no urine production)
• Low blood pressure, weak pulse

As blood pressure drops further, symptoms of septic shock appear:

• Abnormally high or low body temperature
• Dizziness
• Skin rash or discoloration
• Severe confusion
• Deep drowsiness
• Inability to stand up
• Loss of consciousness

Causes

Sepsis is caused by a bacterial infection, although in some cases it can be viral, fungal, or parasitic. The toxins produced by bacteria cause the body’s cells to release cytokines, proteins responsible for coordinating the immune response. These proteins, in turn, lead to blood vessel dilation and promote blood clot formation in vessels within the organs.

Risk Factors

Anyone with an infection can develop sepsis, but certain factors increase the risk:

• Age: Septic shock is more common in newborns (neonatal sepsis) and adults over 65.
• Chronic diseases such as diabetes, cancer, lung disease, or kidney disease.
• Immune system disorders
• Pregnancy: Septic shock is more frequent in pregnant women.
• Prolonged hospitalization or admission to the intensive care unit.
• Invasive intravenous devices, such as catheters or IV lines.
• Antibiotic or corticosteroid treatments, which weaken the immune response.

Complications

Although most people recover from mild septicemia, if it progresses to septic shock, the mortality rate is very high. Additionally, survivors may experience lasting physical and psychological effects and have a higher risk of future infections.

Prevention

The key to reducing the risk of sepsis is to take measures to prevent infection:

• Vaccination
• Good hygiene practices and frequent handwashing
• Keeping wounds clean and protected

Which Doctor Treats Sepsis?

Due to its urgency and severity, sepsis is primarily treated in the intensive care unit or emergency department. However, as it causes multiple organ failure and can have various underlying causes, its diagnosis and treatment involve a multidisciplinary team of specialists.