September is Sepsis Awareness Month: Every time I walk into the emergency room to admit a patient diagnosed with sepsis, I meet patients who are very scared but do not entirely understand their diagnosis. Sepsis is a life-threatening condition caused by the body’s response to an infection and can lead to tissue damage, organ failure and potentially death.
Sepsis is currently the 3rd leading cause of death in the United States. About 258,000 Americans die every year from sepsis. In one year in the US, about 17 million people are diagnosed with sepsis.
Most cases of sepsis start in the community as a medical emergency. Early detection and quick and proper treatment reduce the risk of death and complications from sepsis. The risk of death increases each hour that treatment is delayed. Understanding sepsis increases the potential to seek medical care early if you may be experiencing symptoms of sepsis.
When there is an infection in the body, the body reacts to fight the infection by releasing chemicals into the bloodstream, which then trigger inflammatory responses throughout the body. This also leads to an increase in the white blood cell count (the blood cell component that fights infection). These chemicals trigger a cascade of changes that cause damage to multiple organs which eventually leads to failure. There is increased metabolism leading to increased heart rate and respiration rate. If the rate of metabolism is too rapid, there is insufficient time for adequate oxygen supply to the body cells which impairs function at the cellular level and leads to the production of excessive acids in the body (lactic acid).
Sepsis may be seen as a three-stage syndrome. During the initial stage, we have sepsis that includes a source of infection and any two of the following: fever, increased heart rate, respiratory rate, and white blood cell count. With the progression of these symptoms and increased acid in the body, severe sepsis can develop. Severe sepsis is associated with increased acid in the blood and other symptoms such as difficulty breathing, confusion, and decreased urination. When severe sepsis progresses, septic shock can develop with low blood pressure not responding to intravenous fluids given in the emergency room. On many occasions, failure of multiple organs can occur. This can include kidney failure, abnormal heart function, liver failure, mental status changes, and breathing difficulties.
Sepsis is usually more common and severe in people at the extremes of life (very young or very old), those with a compromised immune system (cancer patients on chemotherapy, HIV, autoimmune diseases on immune-suppressing medications), and some presenting with disease conditions like diabetes mellitus, severe wounds and injuries like burns, presence of invasive devices like breathing tubes and urinary catheters.
If you or a loved one has an infection which may be related to urination (pain with urination, frequent urination or change in the order or color of urine, flank pain), breathing (cough, difficulty breathing, chest pain, sore throat, runny nose), the intestinal tract (nausea, vomiting, diarrhea or abdominal pain) and has fever and chills, then you need to look out for developing symptoms that can be concerning for sepsis. Check for fever (temp over 100.4 degrees F) or low temperature, fast breathing or complaints of the heart racing. If the infection is complicated by any of the symptoms above or is not getting better or is getting worse, act FAST, call your doctor, or go to the nearest urgent care or emergency room for treatment.
Early intervention and timely care is the key to survival. Appropriate cultures will need to be done in a timely manner. Antibiotics and intravenous hydration should be given in the appropriate time frame. Other support, such as oxygen, will also be provided as needed.
Chinwe Aligwekwe, MD
Hospitalist at Eastside Medical Center
1700 Medical Way
Snellville, GA, 30078