Sepsis

Also known as blood poisoning, septicemia

Even though blood poisoning, septicemia and sepsis are frequently used interchangeably, there are differences.

• The trend in medicine currently is to decrease the use of the terms septicemia and blood poisoning in favor of the terms sepsis or septic, because sepsis is defined most concisely.

Blood Poisoning: occurs when bacteria are in the bloodstream. Although not a medical term, “blood poisoning” is used to describe bacteremia, septicemia, or sepsis.

• Sometimes a doctor or  nurse may say “blood poisoning” because they realize this is a term many people are familiar with.
• Blood poisoning is a nonspecific term used mainly by nonmedical individuals that describes, in the broadest sense, any adverse medical condition(s) due to the presence of any toxic agent in the blood. Usually, the layperson using the term blood poisoning is referring to the medical condition(s) that arise when bacteria or their products (or both) reach the blood. Blood poisoning is not a medical term and does not appear in many medical dictionaries or scientific publications.
  • However, when it is used, the correct medical term that most closely matches its intended meaning is sepsis. Many medical authors consider the terms blood poisoning and sepsis to be interchangeable, but the trend in the medical literature is to use the term sepsis.

The terms “septicemia” and “sepsis” are often used interchangeably, though technically they aren’t quite the same.

• Septicemia, the state of having bacteria in your blood, can lead to sepsis.
  • It’s also known as bacteremia, or blood poisoning.
  • The presence of bacteria in the blood is referred to as bacteremia or septicemia.
  • Septicemia occurs when a bacterial infection elsewhere in the body, such as in the lungs or skin, enters the bloodstream. This is dangerous because the bacteria and their toxins can be carried through the bloodstream to your entire body.
  • Septicemia can quickly become life-threatening.
  • It must be treated in a hospital.
  • If it’s left untreated, septicemia can progress to sepsis.
  • Septicemia often cannot be traced to a single microorganism but results from multiple infections, so that broad-spectrum antibiotic therapy may be required. If not treated promptly with appropriate antibiotics and surgical drainage of any detectable foci of infection, septicemia is followed by septic shock, in which the mortality rate exceeds 50 percent.
  • The terms "septicemia", also spelled "septicaemia", and "blood poisoning" referred to the microorganisms or their toxins in the blood and are no longer commonly used. The modern term for this is bacteremia.
• Sepsis is a serious complication of septicemia. It is often a life-threatening state of infection if it’s left untreated.
  • Blood poisoning can progress to sepsis rapidly. Prompt diagnosis and treatment are essential for treating blood poisoning, but understanding your risk factors is the first step in preventing the condition.
  • Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. This inflammation can cause blood clots and block oxygen from reaching vital organs, resulting in organ failure.
  • The National Institutes of Health (NIH) estimates that over 1 million Americans get severe sepsis each year. Between 28 and 50 percent of these patients may die from the condition. When the inflammation occurs with extremely low blood pressure, it’s called septic shock. Septic shock is fatal in many cases.
  • Sepsis is a severe, but any type of infection — whether bacterial, fungal, or viral — can cause sepsis. And these infectious agents don’t necessarily need to be in a person’s bloodstream to bring about sepsis.
  • There are three stages of sepsis: sepsis, severe sepsis, and septic shock.

Anyone can get blood poisoning and sepsis, but the risk is higher for:

• Infants and young children (especially those under 1 year of age).
• The elderly (65 years of age or older).
• People who have a weakened immune system.
• People who already suffer from a chronic disease or medical condition, such as AIDS, diabetes, or cancer.
• People who have just had surgery.

Causes:

Septicemia is caused by an infection in another part of your body. This infection is typically severe. Many types of bacteria can lead to septicemia. The exact source of the infection often can’t be determined. The most common infections that lead to septicemia and sepsis are:

• urinary tract infections
• lung infections, such as pneumonia
• kidney infections
• infections in the abdominal area
• bloodstream infections

Bacteria from these infections enter the bloodstream and multiply rapidly, causing immediate symptoms. The typical microorganisms that produce septicemia, usually gram-negative bacteria, release toxic products that trigger immune responses and widespread blood clotting (coagulation) within the blood vessels, thus reducing the flow of blood to tissues and organs.

People who are already in the hospital for something else, such as a surgery, are at a higher risk of developing septicemia. Secondary infections can occur while in the hospital. These infections are often more dangerous because the bacteria may already be resistant to antibiotics.

Symptoms

The most common initial symptoms are:

• chills
• elevated body temperature (fever)
• very fast respiration
• rapid heart rate
• weakness
• excessive sweating
• decreased blood pressure

More severe symptoms will begin to emerge as the septicemia progresses without proper treatment. These include the following:

• confusion or inability to think clearly
• nausea and vomiting
• red dots that appear on the skin
• reduced urine volume
• inadequate blood flow (shock)

Complications of septicemia

Septicemia has a number of serious complications. These complications may be fatal if left untreated or if treatment is delayed for too long.

• Sepsis
  • Sepsis occurs when your body has a strong immune response to the infection. This leads to widespread inflammation throughout the body. It’s called severe sepsis if it leads to organ failure. People with chronic diseases, such as HIV or cancer, are at a higher risk of sepsis. This is because they have a weakened immune system and can’t fight off the infection on their own.
• Septic shock
  • One complication of septicemia is a serious drop in blood pressure. This is called septic shock. Toxins released by the bacteria in the bloodstream can cause extremely low blood flow, which may result in organ or tissue damage. Septic shock is a medical emergency. People with septic shock are usually cared for in a hospital’s intensive care unit (ICU). You may need to be put on a ventilator, or breathing machine, if you’re in septic shock.
• Acute respiratory distress syndrome (ARDS)
  • A third complication of septicemia is acute respiratory distress syndrome (ARDS). This is a life-threatening condition that prevents enough oxygen from reaching your lungs and blood. According to the National Heart, Lung, and Blood Institute (NHLBI), ARDS is fatal in about one-third of cases. It often results in some level of permanent lung damage. It can also damage your brain, which can lead to memory problems.

Prognosis:

• Many people who develop blood poisoning have a full recovery and go on to lead normal lives. However, once you have had blood poisoning, you are at higher risk for developing infections in the future.
• When diagnosed very early, septicemia can be treated effectively with antibiotics.
• When blood poisoning progresses to sepsis, it can affect internal organs such as your kidneys and heart. At this stage, the damage done to these organs may be irreversible. For example, kidney damage could lead to lifelong dialysis.
  • Even with treatment, it’s possible to have permanent organ damage. This is especially true for people with pre-existing conditions that affect how well their immune systems work.
• According to a study published in Critical Care Medicine, the hospital mortality rate from severe sepsis has decreased from 47 percent (between 1991 and 1995) to 29 percent (between 2006 and 2009).
• There are more than 1,000,000 cases of sepsis each year, according to the Centers for Disease Control and Prevention (CDC). This type of infection kills more than 258,000 Americans a year.
• Neonatal sepsis is still a leading cause of infant death, but with early diagnosis and treatment, the baby will recover completely and have no other problems. With maternal universal screening and proper neonatal testing the risk of neonatal sepsis has decreased significantly.
• Since our immune system weakens as we age, seniors can be at risk for sepsis.
• According to the Mayo Clinic, septic shock has a 50 percent mortality rate. Even if treatment is successful, sepsis can lead to permanent damage.
• Approximately 20–35% of people with severe sepsis and 30–70% of people with septic shock die.
• The worldwide incidence of sepsis is estimated to be 18 million cases per year.
• In the United States sepsis affects approximately 3 in 1,000 people, and severe sepsis contributes to more than 200,000 deaths per year.
• Sepsis occurs in 1–2% of all hospitalizations and accounts for as much as 25% of ICU bed utilization.
• Sepsis was the most expensive condition treated in United States' hospital stays in 2013, at an aggregate cost of $23.6 billion for nearly 1.3 million hospitalizations. Costs for sepsis hospital stays more than quadrupled since 1997 with an 11.5 percent annual increase. By payer, it was the most costly condition billed to Medicare and the uninsured, the second-most costly billed to Medicaid, and the fourth-most costly billed to private insurance.

Famous People Who Died of Sepsis

1. Ranker - Famous People Who Died of Sepsis (73 people listed)
2. Wikipedia - Deaths from sepsis (162 people listed)

• Patty Duke (1946-2016) - actress; Died from sepsis from a ruptured intestine (Huffpost - Patty Duke’s Death Announcement is a Milestone for Sepsis Awareness. by Anna Almendraia, 30 Mar 2016)

Resources & Additional Reading

• Healthline - Septicemia. by: Krista O’Connell & Jacquelyn Cafasso, 5 Nov 2015
• Encyclopaedia Britannica - Septicemia. updated 25 Jun 2018
• Healthline - Blood Poisoning: Symptoms and Treatment. Written by Erica Cirino; Medically reviewed by Xixi Luo, MD. July 18, 2017
• Family Doctor - Blood poisoning
• Sepsis Alliance - Sepsis and Blood poisoning. updated 13 Dec 2017
• Mayo Clinic - Blood poisoning: When to see a doctor. Answer from James M Steckelberg, MD
• MedicineNet.com - Sepsis (Blood Poisoning). Medical Author: Charles Patrick Davis, MD, PhD
• Why are there so many diseases with “sepsis,” “septic,” “septicemia,” or “blood poisoning” in their name?
• Wikipedia - Sepsis

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