Sepsis is a serious systemic infection caused by bacteria in the bloodstream.
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Group B streptococcus
What Is Sepsis?
Sepsis is caused most commonly by bacteria in the bloodstream, a condition known as bacteremia (bak-tuh-REE-me-uh). These bacteria produce toxins * that provoke a response by the body's immune system. The effect of the toxins combined with the response of the immune system brings about the disease. Bacteremia may resolve on its own or it can lead to sepsis if the bacteria are not removed by the immune system. Although bacteremia and sepsis frequently coexist, each can be present without the other. The bacteria may come from a local infection, like pneumonia * or a urinary tract * infection, or they may come from the nose, skin, or intestines * , where bacteria live without causing problems unless they enter the bloodstream. The most common sources of infection that lead to sepsis are the lungs, skin, intestine, urinary tract, and gall bladder * .
Sepsis is most dangerous to people with weak immune systems, such as infants, the elderly, people with HIV/AIDS or cancer, or those who have undergone organ transplantation. In infants younger than 3 months, any fever may be a sign of sepsis or another serious infection. Doctors advise immediate evaluation of these infants and prompt treatment with antibiotics if sepsis is suspected. Group B streptococcus (strep-tuh-KAH-kus) bacteria passed from mother to baby during birth are a major cause of sepsis in infants. Streptococcus pneumoniae (strep-tuh-KAH-kus nu-MO-nye) and Neisseria meningitidis (nye-SEER-e-uh meh-nin-JIH-tih-dis) bacteria are associated with sepsis in older children and in adults. Sepsis in adults most often is seen after surgery or another medical procedure in the hospital, but it may occur outside the hospital, particularly associated with urinary tract infection.
* toxins are poisons that harm the body.
* pneumonia (nu-MO-nyah) is inflammation of the lung.
* urinary tract (YOOR-ih-nair-e TRAKT) is the system of organs and channels that makes urine and removes it from the body. It consists of the urethra, bladder, ureters, and kidneys.
* intestines are the muscular tubes that food passes through during digestion after it exits the stomach.
* gall bladder is a small pear-shaped organ on the right side of the abdomen that stores bile, a liquid that helps the body digest fat.
How Common Is Sepsis?
Sepsis is not very common. According to the U.S. National Library of Medicine, sepsis develops in about 2 of every 10,000 people in the general population. In infants, sepsis occurs in fewer than 1 to 2 per 1,000 live births. Sepsis is a complication in about 2 of every 100 hospitalizations, where related intravenous (IV) lines, surgical wounds or drains, and bedsores * can be entry points for bacteria.
Is Sepsis Contagious?
Sepsis itself is not contagious, but the infectious agents that can cause sepsis can be transmitted from person to person. For example, in newborns, group B streptococcus organisms can spread from mother to baby during delivery.
What Are the Signs and Symptoms of
Early symptoms of sepsis may include fever, shaking chills, rapid breathing and heartbeat, confusion, delirium * , and rash. As the infection spreads, a person's blood pressure drops, leading to a condition known as shock * . Body organs that have important functions, including the liver, lungs, and kidneys, may begin to shut down. The blood-clotting * system also may be affected. Sepsis in young children may be more difficult to diagnose at first, because it has fewer obvious symptoms. Children may have a fever or changing temperature, a change in heart rate, or difficulty breathing. They also might be irritable or sluggish, and they may lose interest in eating.
How Do Doctors Make the Diagnosis?
A diagnosis of sepsis is made based on a person's symptoms. Blood tests are performed to identify the bacteria and to look for a low platelet * count (an indicator of the blood-clotting problems seen with sepsis) and an abnormally low or high white blood cell count (both can occur with sepsis). Other tests can help show damage to vital organs, such as the kidneys.
Can Sepsis Be Treated?
As soon as a diagnosis of sepsis is suspected, treatment with intravenous antibiotics begins. Patients with sepsis are hospitalized in an intensive care unit, where they may be given oxygen, intravenous fluids, and medication to stabilize blood pressure, treat other symptoms, and kill the bacteria responsible for the condition. Dialysis * may be necessary if the patient's kidneys fail. If respiratory failure * occurs, patients usually are placed on a respirator, a machine that aids their breathing until they can breathe again on their own. If the patient survives, recovery from sepsis can take weeks.
* bedsores, also called pressure sores, are skin sores caused by prolonged pressure on the skin and typically are seen in people who are confined by illness or paralysis to beds or wheelchairs.
* delirium (dih-LEER-e-um) is a condition in which a person is confused, is unable to think clearly, and has a reduced level of consciousness.
* shock is a serious condition in which blood pressure is very low and not enough blood flows to the body's organs and tissues. Untreated, shock may result in death.
* clotting is the body's way of thickening blood to stop bleeding.
* platelets (PLATE-lets) are tiny disk-shaped particles within the blood that play an important role in clotting.
* dialysis (dye-AL-uh-sis) is a process that removes waste, toxins (poisons), and extra fluid from the blood; usually it is done when a person's kidneys are unable to perform these functions normally.
* respiratory failure is a condition in which breathing and oxygen delivery to the body is dangerously altered. This may result from infection, nerve or muscle damage, poisoning, or other causes.
* septic shock is shock due to overwhelming infection and is characterized by decreased blood pressure, internal bleeding, heart failure, and, in some cases, death.
What Are the Complications of the Disease?
Septic shock * may occur in patients with sepsis. Disseminated intravascular coagulation is a complication associated with sepsis in which the body's blood-clotting system is out of control; this can lead to serious internal bleeding. This complication usually improves when the cause of sepsis is treated. Sepsis can be fatal, depending on the infectious agent and on the age and overall health of the patient. Quick diagnosis and treatment can improve outcomes and save lives.
How Is Sepsis Prevented?
Sepsis may not be preventable in many cases, but an early response to symptoms may stop a bacterial infection from progressing to sepsis. This is particularly important with regard to people with weak immune systems. Among hospitalized patients, efforts are made to limit the use of intravenous and urinary catheters * , which are both common entry points for sepsis-causing bacteria. Following a recommended vaccination * schedule for children can lessen their risk of contracting certain infections that might lead to sepsis. Immunization against Streptococcus pneumoniae is recommended for infants and for adults and children at high risk due to age or medical problems. This vaccine is highly effective in preventing pneumonia and sepsis caused by this organism.
Pregnant women typically are tested to determine whether they are carrying group B streptococcus bacteria in their vagina * . Treating these women with antibiotics during pregnancy may reduce the risk of passing the bacterium from mother to child. People with medical conditions, such as sickle-cell disease * , that put them at greater risk for developing serious bacterial infections are prescribed antibiotics to decrease the chance that sepsis can develop.
* catheters (KAH-thuh-ters) are small plastic tubes placed through a body opening into an organ (such as the bladder) or through the skin directly into a blood vessel. They are used to give fluids to or drain fluids from a person.
* vaccination (vak-sih-NAY-shun), also called immunization, is giving, usually by an injection, a preparation of killed or weakened germs, or a part of a germ or product it produces, to prevent or lessen the severity of the disease caused by that germ.
* vagina (vah-JY-nah) is the canal, or passageway, in a woman that leads from the uterus to the outside of the body.
* sickle-cell disease is a hereditary condition in which the red blood cells, which are usually round, take on an abnormal crescent shape and have a decreased ability to carry oxygen throughout the body.
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. KidsHealth is a website created by the medical experts of the Nemours
Foundation and is devoted to issues of children's health. It
contains articles on a variety of health topics, including sepsis.