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Definition
Sepsis is a life-threatening condition, that arises when the body's response to infection causes injury to its own tissues and organs.[1]
Symptoms
Common signs and symptoms include
More specific symptoms
There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection.[3]
Young and old
In the very young, old, and people with a weakened immune systems, there may be no symptoms of a specific infection. The body temperature can also be low or normal, rather than high.[3]
Symptoms of severe sepsis
Severe sepsis, is sepsis that is causing
Septic shock
Septic shock is low blood pressure due to sepsis, that does not improve after fluid replacement.[4]
Causes
Sepsis is caused by an inflammatory immune response, triggered by an infection.[3][5]
Microbiology
Most commonly, the infection is
Risk factors
Risk factors include very young age, older age, and a weakened immune system from conditions such as
Diagnosis
An older method of diagnosis was based on the patient meeting at least two criteria from the systemic inflammatory response syndrome (called SIRS), because of a presumed infection.[3]
Modern diagnosis
In 2016, SIRS was replaced with a shortened sequential organ failure assessment score (called the SOFA score). With the quick SOFA, if the patient has any two of, increased breathing rate, change in their level of consciousness, or low blood pressure, then they meet the criteria.[1]
Blood cultures
Medical imaging
Medical imaging should be used to look for the possible location of infection.[4]
Differential diagnosis
Other potential causes of similar signs and symptoms include, anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism.[3]
Treatment
Sepsis is usually treated with
Antibiotics
Typically, antibiotics are given as soon as possible,[2] with high level care such as in an intensive care unit.[2]
Fluid replacement and blood pressure
If
Monitoring blood pressure
To guide treatment, a
Risks of sepsis
People with sepsis need preventive measures for
Steroid use
The use of
Prognosis
Disease severity partly determines the outcome.[10] The risk of death from sepsis is as high as 30%, from severe sepsis as high as 50%, and from septic shock as high as 80%.[10]
Epidemiology
Millions are affected by sepsis each year, with a rate of 0.2-3 people per thousand, per year in the developed world
Change in rate of disease
It is believed that rates of disease have been increasing[4], and that sepsis is more common among males than females.[3]
History
The medical condition has been described since the time of Hippocrates.[12] The terms "septicemia" and "blood poisoning" have been used in various ways, and are no longer recommended.[12][13]
References
- ^ PMID 26903338.
- ^ a b c d e f g "Sepsis Questions and Answers". cdc.gov. Centers for Disease Control and Prevention (CDC). 22 May 2014. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
- ^ McGraw-Hill. pp. 1003–14. Archivedfrom the original on 15 January 2014. Retrieved 11 December 2012 – via AccessMedicine.
- ^ PMID 23353941. Archived from the original(PDF) on 2 February 2015.
- PMID 24745331.
- PMID 28101605.
- PMID 21680949.
- PMID 26633262.
- PMID 30575845.
- ^ PMID 23198133.
- PMID 22734959.
- ^ PMID 23984731.
- Sara Fazio (30 August 2013). "Severe Sepsis and Septic Shock". The New England Journal of Medicine. Archived from the original on 2013-09-05.
- PMID 1303622.
Septicemia... has been used... in a variety of ways... We therefore suggest that this term be eliminated from current usage.