To talk about sepsis, we first need to explain what the acronym SIRS stands for. SIRS, or systemic inflammatory response syndrome, is a set of symptoms that appear due to an excessive response of the entire body to a factor. These symptoms include:
Sepsis is characterized by a severe, generalized inflammatory response to infections caused by microorganisms or the substances they release into the bloodstream. The term “sepsis” was once widely used, but it is now becoming less common.
It's important to understand that the mere presence of microorganisms in the blood does not automatically result in sepsis and is not even a requisite for its development. Conditions like bacteremia, which is the presence of bacteria in the blood, and viremia, the presence of viruses that can replicate in the blood, frequently occur during infections or even under normal physiological conditions, yet they often do not lead to the symptoms associated with sepsis. Ultimately, the underlying cause of sepsis is inflammation, which is the body's response to defend itself against these intruders.
In the most general outline, hospital sepsis and non-hospital sepsis are distinguished. The former, as the name suggests, occurs in hospital conditions and concerns in particular patients:
Based on the ICD-10 classification, the following forms of endotoxemia are listed, among others:
Due to the circumstances in which the infection occurs, in addition to the above-mentioned neonatal sepsis (in various varieties, such as streptococcal, staphylococcal, or caused by Escherichia Coli), there is also procedural, pregnancy, puerperal, or post-vaccination sepsis.
This problem can also be considered in terms of the location of the infection primary – for example, there is urological sepsis, also known as renal sepsis, as well as intestinal sepsis and many others.
The course of sepsis is exceptionally rapid. Usually, the infection reaches a critical level within just a dozen or so hours. Assuming that in many cases this means severe damage to internal organs and the death of the patient, sepsis is considered one of the fastest-killing ailments that can affect a person. Considering how little time separates the onset of sepsis from death, it is a shocking experience for patients and their loved ones. Especially if the patient's general condition was previously good.
Understanding how sepsis develops involves a complex pathophysiology. It begins with an infection at the tissue and cellular level, characterized by an uncontrolled and cascading reaction triggered by the release of pro-inflammatory cytokines in response to an inflammatory factor.
This inflammatory factor is frequently lipopolysaccharide (LPS), a toxin produced by Gram-negative bacteria. In the case of Gram-positive bacteria, the factors include teichoic acids, lipoteichoic acids, and peptidoglycan.
These reactions disturb the balance between pro-inflammatory and anti-inflammatory effects in the body. Initially, the immune system is stimulated, leading to leukocytosis, which is an increase in white blood cells, along with elevated levels of procalcitonin and other proteins.
Following this pro-inflammatory phase, the body enters an immunodepressive stage where leukocytosis shifts to leukopenia, a state characterized by a decrease in white blood cell count. Blood pressure drops rapidly during this process, resulting in reduced blood flow and subsequent tissue hypoxia.
The course of sepsis can be varied. Due to the pace and scale of this process, the following are distinguished:
In the individual stages, subsequent internal organs are destroyed and impaired, which quickly leads to their failure.
The aforementioned shock is a critical moment when the body loses its ability to compensate for disturbances in the mechanism of transporting oxygen and nutrients through the blood to the organs. The effect – multi-organ failure and death.
The clinical course of sepsis is non-specific, varying from person to person, and can change in intensity over time. This variability makes early recognition challenging. Symptoms associated with Systemic Inflammatory Response Syndrome (SIRS), which leads to sepsis, are often overlooked or ignored. The lack of a timely response allows the infection to progress, resulting in severe sepsis. This stage is particularly dangerous and is characterized by the failure of at least one organ system. The respiratory system is often the first to be affected, leading to feelings of shortness of breath, followed by potential failures in the circulatory and urinary systems.
DIC (Disseminated Intravascular Coagulation) may develop, when microclots form in the small vessels of organs, causing their hypoxia and impairing their function. All these symptoms are part of a vicious circle – damage to one organ leads to the failure of another, which in turn increases the dysfunction of the first one. If effective treatment is not undertaken, septic shock and multiple organ dysfunction syndrome (MODS) develop.
Both septic shock and MODS represent conditions that the body cannot manage on its own, and if left untreated, they can lead to death.
Symptoms of sepsis are varied:
Such a person is hot and tired, sweats profusely, and febrile convulsions may occur in small children. This is the first phase – SIRS.
An urgent and worrying symptom is the appearance of a dark red, small rash, especially on the trunk and lower limbs, which appears quickly and does not fade when pressed – it may indicate DIC.
Symptoms that may indicate meningitis are also worrying. In adults, these are:
In small children, these can be a loud, piercing cry or overflowing in the hands and a throbbing fontanel.
In severe sepsis, septic shock may also develop (due to the dilation of blood vessels, the proper blood flow through the organs is not maintained), which is manifested by:
Anyone showing symptoms of Systemic Inflammatory Response Syndrome (SIRS), especially if they belong to a high-risk group, should be hospitalized—particularly if they experience shortness of breath or a rash.
If symptoms of meningitis or shock occur, it is crucial to call an ambulance immediately.
After calling for help, you can try to calm the patient and place them in a comfortable position while monitoring their condition. The top priority is ensuring the patient's breathing and circulation. If either stop, you must begin resuscitation, which involves performing chest compressions (indirect heart massage) and providing mouth-to-mouth breathing. Unfortunately, in such cases, the patient’s condition cannot be improved without professional medical assistance and medication.
The main indicator to consider today is a deterioration of the parameters on the SOFA scale by at least 2 points. The SOFA scale is a five-stage tool used to assess organ failure, evaluating the functioning of the liver, kidneys, nervous system, respiratory system, circulatory system, and blood clotting.
Laboratory test results are also crucial. Some tests aim to identify the underlying cause of the condition, such as various types of bacterial cultures from the respiratory tract, cerebrospinal fluid, or secretions from wounds.
Blood tests for sepsis markers are also significant. However, it’s essential to note that none of these markers are specific or sensitive enough to definitively diagnose sepsis. The primary purpose of determining their concentration is to confirm the presence of a significant inflammatory response in the body. Key markers include C-reactive protein (CRP) and a protein called procalcitonin.
Furthermore, we shouldn’t overlook the standard blood morphology test, which can help detect abnormal levels of leukocytes.
In initial, at-home diagnostics—especially for small children—the “glass test” is often used. This test is performed on skin covered with a rash. If, after pressing on a spot with a glass vessel, the petechiae do not change color, it may indicate sepsis of meningococcal origin.
Treatment for severe sepsis is crucial. The primary objective is to eliminate the source of the infection, if feasible, and to administer antimicrobial drugs (antibiotics) that are specifically targeted to the identified pathogen. Alongside this, symptomatic treatment aims to improve or support the function of the affected organs.
If shock occurs, hydration and vasoconstrictor medications are employed to increase blood pressure. In many cases, the patient may need to be connected to a ventilator, have a catheter inserted into the urinary bladder, or even undergo temporary dialysis in the event of kidney failure. Treatment is typically conducted in intensive care units and can be prolonged. The earlier treatment begins and the more specifically it targets the pathogen, the more effective it will be, leading to a better prognosis.
Yes, it is possible to completely cure the bacterial infection that causes sepsis. However, the consequences of sepsis can result in permanent complications. Even with the best treatment, sepsis carries a significant mortality rate of 30-50%.
After surviving sepsis, numerous complications can arise, including necrotic changes in the extremities, such as fingers and toes, which may necessitate amputation, as well as skin defects. In cases of cerebral hypoxia, along with coexisting meningitis or brain abscesses, patients may experience lasting neurological complications after sepsis. These complications can include epileptic seizures, hearing loss, motor paralysis of the limbs, or various disorders affecting higher nervous functions, such as memory issues or emotional disturbances.
The contagiousness of sepsis, or its ability to spread to healthy individuals, varies depending on the specific cause of the condition. Since sepsis can be triggered by a wide range of microorganisms, its potential to be contagious is not consistent. Among these, meningococcal sepsis is considered the most contagious and can lead to outbreaks. In contrast, sepsis treated in a hospital setting is generally not contagious. A patient with sepsis typically stops being a source of infection after the first day of effective antibiotic treatment.
Sepsis rarely leaves resistance and can be caused by various microorganisms. Its recurrence typically indicates underlying risk factors, such as immunodeficiencies.
There is no 100% way to protect against sepsis, but knowing the mechanism of its development, you can try to reduce the risk of illness by:
This does not guarantee absolute protection against sepsis, but it increases the chance of curing it.
To talk about sepsis, we first need to explain what the acronym SIRS stands for. SIRS, or systemic inflammatory response syndrome, is a set of symptoms that appear due to an excessive response of the entire body to a factor. These symptoms include:
Sepsis is characterized by a severe, generalized inflammatory response to infections caused by microorganisms or the substances they release into the bloodstream. The term “sepsis” was once widely used, but it is now becoming less common.
It's important to understand that the mere presence of microorganisms in the blood does not automatically result in sepsis and is not even a requisite for its development. Conditions like bacteremia, which is the presence of bacteria in the blood, and viremia, the presence of viruses that can replicate in the blood, frequently occur during infections or even under normal physiological conditions, yet they often do not lead to the symptoms associated with sepsis. Ultimately, the underlying cause of sepsis is inflammation, which is the body's response to defend itself against these intruders.
In the most general outline, hospital sepsis and non-hospital sepsis are distinguished. The former, as the name suggests, occurs in hospital conditions and concerns in particular patients:
Based on the ICD-10 classification, the following forms of
endotoxemia are listed, among others:
Due to the circumstances in which the infection occurs, in addition to the above-mentioned neonatal sepsis (in various varieties, such as streptococcal, staphylococcal, or caused by Escherichia Coli), there is also procedural, pregnancy, puerperal, or post-vaccination sepsis.
This problem can also be considered in terms of the location of the infection primary – for example, there is urological sepsis, also known as renal sepsis, as well as intestinal sepsis and many others.
The course of
sepsis is exceptionally rapid. Usually, the infection reaches a critical level within just a dozen or so hours. Assuming that in many cases this means severe damage to internal organs and the death of the patient, sepsis is considered one of the fastest-killing ailments that can affect a person. Considering how little time separates the onset of sepsis from death, it is a shocking experience for patients and their loved ones. Especially if the patient's general condition was previously good.
Understanding how sepsis develops involves a complex pathophysiology. It begins with an infection at the tissue and cellular level, characterized by an uncontrolled and cascading reaction triggered by the release of pro-inflammatory cytokines in response to an inflammatory factor.
This inflammatory factor is frequently lipopolysaccharide (LPS), a toxin produced by Gram-negative bacteria. In the case of Gram-positive bacteria, the factors include teichoic acids, lipoteichoic acids, and peptidoglycan.
These reactions disturb the balance between pro-inflammatory and anti-inflammatory effects in the body. Initially, the immune system is stimulated, leading to leukocytosis, which is an increase in white blood cells, along with elevated levels of procalcitonin and other proteins.
Following this pro-inflammatory phase, the body enters an immunodepressive stage where leukocytosis shifts to leukopenia, a state characterized by a decrease in white blood cell count. Blood pressure drops rapidly during this process, resulting in reduced blood flow and subsequent tissue hypoxia.
The course of sepsis can be varied. Due to the pace and scale of this process, the following are distinguished:
In the individual stages, subsequent internal organs are destroyed and impaired, which quickly leads to their failure.
The aforementioned shock is a critical moment when the body loses its ability to compensate for disturbances in the mechanism of transporting oxygen and nutrients through the blood to the organs. The effect – multi-organ failure and death.
The clinical course of sepsis is non-specific, varying from person to person, and can change in intensity over time. This variability makes early recognition challenging. Symptoms associated with
Systemic Inflammatory Response Syndrome (SIRS), which leads to sepsis, are often overlooked or ignored. The lack of a timely response allows the infection to progress, resulting in severe sepsis. This stage is particularly dangerous and is characterized by the failure of at least one organ system. The respiratory system is often the first to be affected, leading to feelings of shortness of breath, followed by potential failures in the circulatory and urinary systems.
DIC (
Disseminated Intravascular Coagulation) may develop, when microclots form in the small vessels of organs, causing their hypoxia and impairing their function. All these symptoms are part of a vicious circle – damage to one organ leads to the failure of another, which in turn increases the dysfunction of the first one. If effective treatment is not undertaken, septic shock and
multiple organ dysfunction syndrome (MODS) develop.
Both septic shock and MODS represent conditions that the body cannot manage on its own, and if left untreated, they can lead to death.
Symptoms of sepsis are varied:
Such a person is hot and tired, sweats profusely, and febrile convulsions may occur in small children. This is the first phase – SIRS.
An urgent and worrying symptom is the appearance of a dark red, small rash, especially on the trunk and lower limbs, which appears quickly and does not fade when pressed – it may indicate DIC.
Symptoms that may indicate meningitis are also worrying. In adults, these are:
In small children, these can be a loud, piercing cry or overflowing in the hands and a throbbing fontanel.
In severe sepsis,
septic shock may also develop (due to the dilation of blood vessels, the proper blood flow through the organs is not maintained), which is manifested by:
Anyone showing symptoms of Systemic Inflammatory Response Syndrome (SIRS), especially if they belong to a high-risk group, should be hospitalized—particularly if they experience shortness of breath or a rash.
If symptoms of meningitis or shock occur, it is crucial to call an ambulance immediately.
After calling for help, you can try to calm the patient and place them in a comfortable position while monitoring their condition. The top priority is ensuring the patient's breathing and circulation. If either stop, you must begin resuscitation, which involves performing chest compressions (indirect heart massage) and providing mouth-to-mouth breathing. Unfortunately, in such cases, the patient’s condition cannot be improved without professional medical assistance and medication.
The main indicator to consider today is a deterioration of the parameters on
the SOFA scale by at least 2 points. The SOFA scale is a five-stage tool used to assess organ failure, evaluating the functioning of the liver, kidneys, nervous system, respiratory system, circulatory system, and blood clotting.
Laboratory test results are also crucial. Some tests aim to identify the underlying cause of the condition, such as various types of bacterial cultures from the respiratory tract, cerebrospinal fluid, or secretions from wounds.
Blood tests for sepsis markers are also significant. However, it’s essential to note that none of these markers are specific or sensitive enough to definitively diagnose sepsis. The primary purpose of determining their concentration is to confirm the presence of a significant inflammatory response in the body. Key markers include C-reactive protein (CRP) and a protein called procalcitonin.
Furthermore, we shouldn’t overlook the standard blood morphology test, which can help detect abnormal levels of leukocytes.
In initial, at-home diagnostics—especially for small children—the “glass test” is often used. This test is performed on skin covered with a rash. If, after pressing on a spot with a glass vessel, the petechiae do not change color, it may indicate sepsis of meningococcal origin.
Treatment for severe sepsis is crucial. The primary objective is to eliminate the source of the infection, if feasible, and to administer antimicrobial drugs (antibiotics) that are specifically targeted to the identified pathogen. Alongside this, symptomatic treatment aims to improve or support the function of the affected organs.
If shock occurs, hydration and vasoconstrictor medications are employed to increase blood pressure. In many cases, the patient may need to be connected to a ventilator, have a catheter inserted into the urinary bladder, or even undergo temporary dialysis in the event of kidney failure. Treatment is typically conducted in intensive care units and can be prolonged. The earlier treatment begins and the more specifically it targets the pathogen, the more effective it will be, leading to a better prognosis.
Yes, it is possible to completely cure the bacterial infection that causes sepsis. However, the consequences of sepsis can result in permanent complications. Even with the best treatment, sepsis carries a significant mortality rate of 30-50%.
After surviving sepsis, numerous
complications can arise, including necrotic changes in the extremities, such as fingers and toes, which may necessitate amputation, as well as skin defects. In cases of cerebral hypoxia, along with coexisting meningitis or brain abscesses, patients may experience lasting neurological complications after sepsis. These complications can include epileptic seizures, hearing loss, motor paralysis of the limbs, or various disorders affecting higher nervous functions, such as memory issues or emotional disturbances.
The contagiousness of sepsis, or its ability to spread to healthy individuals, varies depending on the specific cause of the condition. Since sepsis can be triggered by a wide range of microorganisms, its potential to be contagious is not consistent. Among these, meningococcal sepsis is considered the most contagious and can lead to outbreaks. In contrast, sepsis treated in a hospital setting is generally not contagious. A patient with sepsis typically stops being a source of infection after the first day of effective antibiotic treatment.
Sepsis rarely leaves resistance and can be caused by various microorganisms. Its recurrence typically indicates underlying risk factors, such as immunodeficiencies.
There is no 100% way to protect against sepsis, but knowing the mechanism of its development, you can try to reduce the risk of illness by:
This does not guarantee absolute
protection against sepsis, but it increases the chance of curing it.
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