Septicemia is a medical emergency. It needs urgent treatment in hospital. Anyone who becomes ill after an infection should get medical help straight away.
This is especially important for people who are more vulnerable to infection, including older people and the very young, or those with long-term illness.
What is septicemia, what is sepsis?
The bloodstream should be completely free of microbes, but when bacteria get into it, this is called bacteremia.
Doctors now tend to use the term sepsis instead of septicemia or blood poisoning.
If the bacteria multiply, the body reacts by releasing chemicals into the bloodstream. These chemicals cause an inflammatory response which can cause damage to the body’s organs. This is when a blood infection is called septicemia.
Septicemia is also known as “blood poisoning,” but this term is no longer used by doctors. Doctors also tend to use the term sepsis instead of septicemia.
Sepsis is easier to use because the term is less narrow than septicemia. Sepsis can be diagnosed and treated without knowing what the infection is. Doctors recognize the importance of seeing sepsis as a life-threatening response of the body, which can happen with or without septicemia.
Sepsis has two clear stages:
Urgent antibiotic treatment is needed just the same, whether it is septicemia or sepsis. This article uses sepsis to include septicemia.
The most up-to-date definition of sepsis is in international guidelines followed by doctors. These give the following meaning for the public:
“In lay terms, sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs.”
Who is at risk of sepsis and septicemia?
Anyone can get sepsis, but some people are more vulnerable. These factors increase the risk:
- Weak immune system – a range of conditions, including AIDS, and treatments, including chemotherapy, can cause this
- Age – babies, children, and older people are most at risk
- Long-term illnesses, including diabetes, cancer, and kidney or liver disease
- Severe burns or other physical trauma
- Undergoing surgery
Symptoms and early signs of sepsis
It is an important time to get emergency care if any of the early signs show and there is a chance of sepsis. Early signs of sepsis include:
- Fever – high temperature
- Low temperature, with chills and shivering
- Fast heart rate
- Fast breathing
- Unusual amount of sweating
- Rash – sometimes appearing as pinpricks of blood in the skin
- Change to the mental state – such as feeling sleepy, confused, or losing interest
If there is any suspicion of sepsis, people should not delay in calling an ambulance for any of the following symptoms:
Sepsis can cause symptoms such as dizziness, nausea, and cold skin.
- Feeling dizzy or faint
- Being confused or losing alertness
- Any other unusual mental change, including a feeling of doom or a fear of death
- Slurred speech
- Diarrhea, nausea, or vomiting
- Severe muscle pain and extreme overall discomfort
- Difficulty breathing
- Passing very little urine
- Cold, clammy, or discolored skin (pale or mottled)
- Cold and pale at the extremities – but get medical help whether hands and feet are cold or unusually warm
- Loss of consciousness
The above symptoms could signal septic shock.
When getting medical help for possible sepsis, it is important to mention any recent infection, surgery, or immune system problems. This will alert doctors to the possibility of sepsis for the quickest possible treatment.
Treatment of sepsis and septicemia
There are two steps to the emergency treatment of someone with sepsis. One is to give antibiotics; the other is to protect the organs by supporting vital functions such as breathing.
Whenever doctors suspect sepsis or septic shock, they will immediately:
- Give antibiotics to cover the most likely bacterial infection
- Do a test to find out the specific infection
- Quickly switch the drugs if test results demand it
If doctors suspect a source of the infection, they will try to remove it. This can involve removing infected tissue, draining abscesses, or taking away possibly infected medical tubes.
The microbes behind sepsis are almost always bacteria. But sepsis can also happen because of other bloodstream infections. The term “septicemia” always means a bacterial infection, however.
Doctors may treat sepsis by putting fluids directly into the bloodstream.
Sepsis is always treated as if it is a bacterial infection for several reasons:
- Bacteria are the most likely cause
- Whatever the exact cause, sepsis shows the same signs, and so doctors cannot base treatment on symptoms
- Doctors do not have enough time to wait and see if the infection is bacterial before trying potentially lifesaving antibiotics
- If doctors do have reason to suspect a fungal infection, they will treat it with antifungals straight away
The rest of the sepsis treatment is to protect the patient from damage caused by the body’s reaction to infection. This life support, to keep the organs working and stop the blood pressure falling, includes:
- Oxygen, with machine-assisted breathing if needed
- Fluids put directly into the bloodstream
Imaging tests may also be ordered promptly to help find the source of infection.
Blood tests are analyzed for not just the type of infection but also the stage of sepsis and the extent of organ damage. All blood tests should be done after antibiotics have been started, to avoid delay.
Sepsis is often preventable, and steps against infection are particularly important for people who are at risk.
Steps include getting vaccinated against infections such as the flu and pneumonia, and practicing good general hygiene. This involves regular hand-washing and bathing, and keeping any cuts and scrapes clean.
Anyone who has an infection needs to be alert to the symptoms above and call for help as soon they appear.
Outlook for people with sepsis
Getting quick treatment at the earliest signs of sepsis is important because the later stages are more dangerous.
There are no exact figures for how common sepsis is because of the different ways that sepsis gets recorded. Estimates say it affects a minimum 2 percent of people staying in a hospital.
The total number of cases in the United States is at least 750,000 each year. Half of people with sepsis will be treated in intensive care.
Severe sepsis and septic shock used to be fatal for almost everyone. Modern intensive care has improved the outlook now.
Up to a third of people treated for sepsis die of the condition. However, this is an improvement on the chances some 30 years ago, when 80 percent would die.
Prompt antibiotics and life-support treatments are the key to sepsis survival. Early therapy needs to have started within 6 hours, for example.
Long-term problems after sepsis
Sepsis is a severe complication of infection. Further complication of sepsis itself depends on the organ damage. This generally varies by overall health and the speed of treatment.
Many people who survive severe sepsis recover without long-term problems.
Some people may get lifelong organ damage. This is more likely for those who have a long-standing condition, such as kidney disease. In this case, the kidneys are more likely to become so damaged by sepsis that dialysis is needed.
A charitable organization for survivors of sepsis lists information on its website to show that some people’s lives after sepsis are affected by ongoing physical and psychological problems. The UK Sepsis Trust also say that people’s immune systems can be affected so that they are more likely to get further infections.