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Sepsis is a severe illness caused by infection of the bloodstream by toxin-producing bacteria. Sepsis can begin from any site of infection , including such common sources as urinary tract infection, pneumonia, and open wounds such as bedsores and cellulitus. Without timely and appropriate treatment, sepsis can result in death.

Statistics

This year in the U.S.

* Sepsis will occur in 2 of every 100 hospital admissions
* Approximately 400,000 men and women will develop sepsis
* Approximately 100,000 men and women will die from sepsis
* Septic shock will be the most common cause of death in intensive care units
* Septic shock will be the 13th most common cause of death

Signs and Symptoms of Sepsis

The signs and symptoms of sepsis arise differently depending on the nature of the underlying source of infection. For example, if sepsis begins with a bed sore, there may be such signs as inflammation, redness, and infection of the bed sore and surrounding area. If sepsis begins with a urinary tract infection, there may be flank pain and difficulty with urination. As sepsis progresses, more signs and symptoms will become noticeable, including:

* Fever or hypothermia (low body temperature)
* Hyperventilation
* Chills
* Shaking
* Inflammation
* Rapid heart beat (tachycardia)
* Confusion or delirium
* Hypotension
* Lactic academia
* Progressive organ system dysfunction

If a patient reports to a doctor with signs of an infection and demonstrates symptoms such as those described above, the physician should conduct appropriate tests to rule out sepsis.

Diagnosing Sepsis

There are a number of tests that can be ordered to determine whether sepsis is present when a patient presents with signs and symptoms that are consistent with sepsis. These include:

* White blood cell count that is low or high
* Platelet count that is low
* Blood culture that is positive for bacteria
* Blood gases that reveal acidosis
* Kidney function tests that are abnormal (early in the course of disease)
* Peripheral smear may demonstrate a low platelet count and destruction of red blood cells
* Fibrin degradation products are often elevated, a condition that may be associated with a tendency to bleed
* Blood differential -- with immature white blood cells seen

Treating Sepsis

Sepsis requires timely and appropriate treatment that generally requires monitoring in an intensive care unit (ICU), the removal of sources such as infected intravenous lines or surgical drains, surgical draining of sources such as abscesses, and "broad spectrum" antibiotic therapy. The type and number of antibiotics administered can be refined once blood cultures and other diagnostic testing identify the causative organism. Supportive therapy with oxygen, intravenous fluids, and medications that increase blood pressure may also be required for a good outcome. Further, dialysis may be necessary in the event of kidney failure, and mechanical ventilation is often required if respiratory failure occurs.

Complications from Sepsis

If not diagnosed and treated in a timely fashion, sepsis can result in severe complications. These include septic shock in which there is low blood pressure, low blood flow, and the failure of vital organs, such as the brain, heart, kidneys, and liver. Another complication is disseminated intravascular coagulation, a disorder of diffuse activation of the clotting cascade that results in the depletion of clotting factors in the blood. Sepsis can also result in death. The death rate can be as high as 60% for people with underlying medical problems. The longer diagnosis and treatment are delayed, the higher the likelihood of complication and death.