Sepsis (Systemic inflammatory response syndrome, SIRS)

What is Sepsis?

Sepsis is a severe illness caused by overwheming infection of the bloodstream by toxin-producing bacteria.This condition can develop either as a result of your body's own defense system or from toxic substances made by the infecting agent (such as a bacteria, virus, or fungus).

Statistics on Sepsis?

Sepsis occurs in approximatley 2 of every 100 hospital admissions. It is caused by bacterial infection that can originate anywhere in the body.

Risk Factors for Sepsis

Those at risk:

Very young people and elderly people

Anyone who has had a transplant

People who are being treated with chemotherapy drugs or radiation

People with long-standing diabetes, AIDS, or cirrhosis

Someone who has very large burns or severe injuries

People with an infection:

Pneumonia
Meningitis
Cellulitis
Urinary tract infection
Ruptured appendix

Progression of Sepsis

The death rate can be as high as 60% for people with underlying medical problems. Mortality is less (but still significant) in individuals without other medical problems. Complications:

Septic shock

Impaired blood flow to vital organs (brain, heart, kidneys)

Disseminated intravascular coagulation

How is Sepsis Diagnosed?

White blood cell count that is low or high

Platelet count that is low

Prognosis of Sepsis

The death rate can be as high as 60% for people with underlying medical problems. Mortality is less (but still significant) in individuals without other medical problems.

How is Sepsis Treated?

Septic patients usually require monitoring in an intensive care unit (ICU). "Broad spectrum" intravenous antibiotic therapy should be initiated as soon as sepsis is suspected.The number of antibiotics administered may be decreased when the results of blood cultures become available and the causative organism is identified. The source of the infection should be discovered, if possible, which may mean further diagnostic testing. Sources such as infected intravenous lines or surgical drains should be removed, and sources such as abscesses should be surgically drained.Supportive therapy with oxygen, intravenous fluids, and medications that increase blood pressure may be required for a good outcome. Dialysis may be necessary in the event of kidney failure, and mechanical ventilation is often required if respiratory failure occurs.

Sepsis References

[1] eMEDICINE[2] Fleisher GR: Infectious disease emergencies. In: Textbook of Pediatric Emergency Medicine. 4th ed. 2000: 725-730. [3] Medline Plus[4] Stapczynski S: Bacteremia and septic shock. In: The Clinical Practice of Emergency Medicine. 3rd ed. 2001: 939-942.