Sepsis

A potentially life threatening complication of infection is called as sepsis. Sepsis occurs when our body’s immune system gets activated and causes inflammatory responses all over the body. This inflammation can cause a cascade of events in organs, organ systems leading to their failure.

Septic shock in which blood pressure drops dramatically is the severe case of sepsis and may cause death of patient. Patients with weaker immune systems are more predisposed to develop sepsis.

Early treatment which includes administration of antibiotics and intravenous fluid supplements may save the life of patient.

To be diagnosed with sepsis, two of the following symptoms along with an ongoing infectious process is necessary:

• Body temperature above 101F (38.3) or below 96.8F (36),
• Heart rate higher than 90 beats per minute,
• Respiratory rate higher than 20 breaths a minute.

Sepsis is a three stage syndrome, starting with sepsis and progressing through severe sepsis finally leading to septic shock. The main aim is to recognize and treat the early stage of sepsis before it converts into septic shock.

Severe sepsis

Diagnosis might change to severe sepsis if the patient possesses any one of the following symptoms:

• Significantly decreased urine output,
• abrupt change in mental status,
• decrease in platelet count,
• difficulty breathing,
• abnormal heart function,
• abdominal pain.

Septic shock is a severe cause and the diagnosis is totally based on the following:

• Severe sepsis with low blood pressure which does not adequately respond to fluid replacement therapy.

Any type of bacterial, viral, and fungal infections can lead to sepsis, the most likely infections causing sepsis include:

• Pneumonia,
• Abdominal infection,
• Kidney infection,
• Bloodstream infection(bacteremia).

Incidence of sepsis is increasing in United States. The common causes of this increase are:

• Aging population- Americans live longer and have many people over the age of 65 and their immune system is weak leading to sepsis.
• Drug resistant bacteria- bacteria have special property, they can themselves to become resistant to antibiotics resulting in creation of a bacterial species which cannot be killed by antibiotics. Hence leading to sepsis and septic shock.
• Immunity- people with compromised immune system are commonly affected by different kind of bacteria, virus and fungi resulting in bacteremia and sepsis development.

The diagnosis of sepsis can become difficult because the signs and symptoms in sepsis might resemble other diseases. Usually a bunch of examinations are done to be diagnosed with sepsis.

• Blood tests: a blood sample is taken from two different sights of body and tested for:
  • evidence of infection,
  • clotting problems,
  • abnormal liver or kidney function,
  • impaired availability of oxygen,
  • electrolyte imbalances.
• Laboratory tests: depending on the symptoms doctor will analyze the following: Urine- if doctor suspects urinary tract infections, a urine sample will be taken and tested for presence of microorganisms, wound secretions- testing a sample of wound secretions can help show what type of antibiotic can work, respiratory secretions- if you have wet cough respiratory secretions will be taken and checked for the presence of any pathogen.
• Imaging scans:
  • X-ray using low levels of radiation X-rays are taken to analyze the function of respiratory system,
  • Computerized Tomography- infections of appendix, bowel and pancreas can be easily visualized on CT.
• Ultrasound: ultrasound can be particularly used to check gallbladder and ovaries.
• Magnetic resonance imaging(MRI): MRI is useful to detect infections of tissues like accesses in spine.   

Early treatment can save the life of patient before sepsis progresses into its most dangerous form septic shock. People with severe sepsis require close monitoring and treatment in intensive care unit.

Medications

• Anti-biotics- treatment with antibiotics should begin immediately to suppress the bacteria which is cause of sepsis. The antibiotics are administered intravenously to treat bacteremia. After accessing the blood results doctor will change to a different type of antibiotic with more efficacy.
• Vasopressors- if the blood pressure of the patient is too low even after receiving intravenous fluid therapy, vasopressors (vasoconstrictors) these drugs constrict the lumen of blood vessel and increase peripheral vascular resistance which will stabilize the blood pressure and heart beat.
• Corticosteroids- to maintain blood sugar level corticosteroids are given.
• Analgesics- drugs that cure pain (pain killers) are administered.
• Immunomodulator- drugs modifying immune response are given.

Supportive care

Includes ingestion of intravenous fluid therapy and oxygen supply.

Surgery

Surgery might be required to remove the focus of infection. 

To prevent sepsis one must avoid contact with the causative agents of infections.

The most common cause of sepsis is infections caused by bacteria, virus and fungi. Healthy eating and hygienic living conditions must be maintained to prevent these infections. In immune compromised people infections are most dominant regular therapy to modulate their immune systems must be taken in order to prevent infections by different pathogens.

To prevent the development of drug resistant bacteria, antibiotics are useful to cure severe bacterial infections. Not while simple fever and coughing, by taking antibiotics in these conditions one might develop a bacterium which is resistant to many different kinds of antibiotics. 

It is never recommended to treat sepsis at home using any home remedies. Sepsis is a life threatening state and serious medical intervention and careful monitoring is needed to treat sepsis. But some house hold herbs which have antibiotic properties can be used such as:

• Turmeric- it an ancient herb used to cure wide range of diseases. To fight sepsis one must add a pinch of turmeric in their food.
• Garlic- another house hold ingredient that can be used to treat sepsis. Garlic contains a compound called allicin which can fight inflammation.
• Honey- studies have shown that honey modulates immune system and helps fight immune system. Vitamin C the antioxidant properties of vitamin C can be used to treat sepsis.
• Mung bean- this bean when consumed reduces the mediator of inflammation and acts as an anti-inflammatory factor.

Lifestyle modifications are necessary in order to cope with sepsis.

A person suffering from sepsis needs careful medical intervention and close monitoring because there can be a severe drop in blood pressure due to bacteremia.

Talk therapy-in which special councilors help people learn about the symptoms and complication because these issues should be confronted and dealt with.  

Diaries and journals- keeping a diary or journal of their thoughts and feelings may help them to cope with this situation.

There are several risks and complications associated with sepsis.

Sepsis is more common and is most dangerous in following conditions:

• very young and old patients,
• immunosuppressed people,
• wounds or injuries, such as burns,
• invasive devices, such as catheters or breathing tubes.

Complications

As sepsis becomes severe blood flow to vital organs such as brain, heart, kidneys, lungs is decreased due to drop in blood pressure. Blood clots can be formed in organs, arms, legs and fingers leading to the formation of gangrene. Most people recover from sepsis but mortality rate of septic shock is about 50 percent.