Definition

Sepsis refers to a bacterial infection in the bloodstream
or body tissues. This is a very broad term covering
the presence of many types of microscopic diseasecausing
organisms.

Description

Sepsis is also called bacteremia. Closely related
terms include septicemia and septic syndrome. In the
general population, the incidence of sepsis is two people
in 10,000.

Causes and symptoms

Sepsis can originate anywhere bacteria can gain
entry to the body; common sites include the genitourinary
tract, the liver and its bile ducts, the gastrointestinal
tract, and the lungs. Broken or ulcerated skin can also
provide access to bacteria commonly present in the environment.
Invasive medical procedures, including dental
work, can introduce bacteria or permit it to accumulate.
Entry points and equipment left in place for any length of
time present a particular risk. Heart valve replacement,
catheters, ostomy sites, intravenous (IV) or arterial lines,
surgical wounds, or surgical drains are examples. IV
drug users are at high risk as well.

People with inefficient immune systems or blood
disorders are at particular risk for sepsis and have a higher
death rate (up to 60%); in people who have no underlying
chronic disease, the death rate is far lower (about
5%). The growing problem of antibiotic resistance has
increased the incidence of sepsis, partly because ordinary
preventive measures (such as prophylactic antibiotics)
are less effective.

The most common symptom of sepsis is fever, often
accompanied by chills or shaking, or other flu-like symptoms.
A history of any recent invasive procedure or dental
work should raise the suspicion of sepsis and medical
help should be sought.

Diagnosis

The presence of sepsis is indicated by blood tests
showing particularly high or low white blood cell counts.
The causative agent is determined by blood culture.

Treatment

Identifying the specific causative agent ultimately
determines how sepsis is treated. However, time is of the
essence, so a broad-spectrum antibiotic or multiple
antibiotics will be administered until blood cultures
reveal the culprit and treatment can be made specific to
the organism. Intravenous antibiotic therapy is usually
necessary and is administered in the hospital.