Sepsis 

Overview:

Sepsis is a condition triggered by an extreme response of the immune system to infections. Usually, infections are cleared out by our immune system or by added medications if the immune system needs help. However, in some cases, the immune system's response to the infection is pushed into overdrive, leading to a life-threatening condition called sepsis.

When a person catches an infection, the immune system releases various chemicals and proteins to fight it. This increases inflammation in the body and keeps the infection (fungi, bacteria, or viruses) from making its way throughout the body. However, if a person contracts sepsis, their immune system causes dysregulated inflammation across the entire body and hinders the blood flow. This can further lead to blood clots in the body, resulting in many health complications.

Furthermore, this condition can also pave the way to organ failure and death. All significant organs might fail one by one or all at once. Some major organs that can be affected by sepsis are the kidneys, the heart, the brain, the liver, and the lungs.

Sepsis progresses quickly and needs to be dealt with as soon as possible. Therefore, if an individual notices signs of sepsis early on, they must get medical help immediately. Sepsis demands treatment from an Intensive Care Unit (ICU).

Stages of Sepsis:

Sepsis has three stages:

1. Sepsis: An infection enters your bloodstream and causes inflammation throughout your body.

2. Severe Sepsis: The infection and inflammation are severe enough to affect organ function.

3. Septic shock: Septic shock is a severe complication of sepsis characterized by a significant drop in blood pressure. This can result in serious complications like

• Organ dysfunction.

• Respiratory or heart failure.

• Stroke 

• Possible death.
  Sepsis is most commonly seen in hospitals, but it can also occur in other settings. Sometimes, you may be unaware that you have an infection that could progress to sepsis.
   

Symptoms:

Here are a few signs of sepsis one must look out for:

• Low blood pressure

• Shivering or chills down the entire body 

• Faster breathing

• High fever 

• Sweaty skin 

• Disorientation 

• Abnormal heart function 

• Decreased urination

In children, the signs of sepsis might manifest differently, as follows:

• Jaundice 

• Lethargy 

• Pauses in breathing 

• Change in skin colour (pale or blue skin)

• Bulging spot on their head

If sepsis is not treated on time, it can pave the way for a septic shock. This condition is an absolute medical emergency and can cause organ failure, tissue damage, and a significant drop in blood pressure.

Causes: 

Sepsis can be caused by almost any type of infection. This includes bacterial, viral, or fungal infections. Common causes of sepsis include:
Infections of the lungs, like pneumonia.
Kidney, bladder, and other parts of the urinary system.
Digestive system.
Bloodstream.
Catheterization sites.
Cuts or burns.

Risk factors:

Factors that increase the risk of infection leading to sepsis include:

• People over the age of 65.

• The infant stage.

• People with a weakened immune system, such as cancer patients or those infected with HIV.

• People suffering from chronic illnesses such as diabetes, kidney disease, or chronic obstructive pulmonary disease (COPD).

• Admission to the intensive care unit or an extended hospital stay.

• In-body devices, such as intravenous catheters or breathing tubes.

• Antibiotic treatment within the last 90 days.

• A condition requiring corticosteroid treatment, which can impair immune response.
   

Complications:

As mentioned earlier, sepsis, if left untreated, can cause significant damage to the human body. The symptoms initially start as mild symptoms. However, if not paid attention to, it can show up in the form of the following:

• Organ damage and failure 

• Tissue death 

• Blood clots 

• Extreme pain

• Unconsciousness 

• Rapid heart rate

• Abnormal heart functions

• Extreme weakness

Sepsis can be fatal as well. If it has stayed in the patient's body for 90 days, the mortality rate for sepsis is 32.2%.

Prevention:

Sepsis can be avoided by treating infections promptly and maintaining good hygiene at home and in healthcare facilities.
The best way to reduce your risk of sepsis is to avoid infections. Steps include:

Maintaining good personal hygiene, such as washing hands and preparing food safely;
Avoiding unclean water and toilets;
Obtaining recommended vaccines from local health officials;
Eating a nutritious diet;
Breastfeeding for newborns;
Antibiotics should be used properly to treat infections.

Sepsis is always a serious condition, but people with HIV, tuberculosis, malaria, and other infectious diseases are at an increased risk.
 

When to Consult a Doctor?

Sepsis is an emergency medical condition, and the patient must get diagnosed as soon as possible so treatment can begin. Usually, people who are already admitted to the ICU have a high risk of contracting sepsis. In such a case, medical staff can detect the signs of sepsis. However, if that is not the case and the individual notices signs and symptoms of sepsis, they must rush to a doctor immediately.
 

Diagnosis:

Here are certain diagnostic tests used to detect the presence of sepsis in the body:

Lab Tests: If a person exhibits signs of sepsis, the doctor runs some preliminary tests to assess the severity of the patient's infection. A doctor might first ask the patient to undergo a blood test. The blood test will include several subtests such as a CBC (complete blood count), blood culture, C-reactive protein, lactate, prothrombin time, platelet count, d-dimer, and partial thromboplastin time test. The blood test will gauge the condition of the body and scan for problems like:

• Decreased oxygen levels in the blood 

• Electrolyte imbalance 

• Infection

• Abnormal kidney functions 

• Abnormal liver function 

• Clotting issues

Depending on the results of the preliminary blood test, the doctor might ask the patient to undergo the following diagnostic tests:

1. Urine Test: This test checks for bacteria present inside the urine.
2. Mucus Secretion Test: This test checks an open wound for possible infection. 
3. Wound Secretion Test: This test gauges and tries to identify any germs responsible for an infection.
 

Imaging Tests: If the lab tests return inconclusive results, the doctor will formulate another medical opinion with the help of various imaging tests as mentioned below:

1. X-ray: An X-ray can detect if the sepsis infection has spread to the patient's lungs. 
2. Magnetic Resonance Imaging: MRIs are used to find and identify an infection in the soft tissue or bones. This imaging test uses radio waves paired with a strong magnet. This combination can produce 3D or cross-sectional images of the internal structure of the human body. 
3. Computerised Tomography: This test is used to detect the presence of infection in the liver, abdomen, and pancreas. A CT scan captures X-rays from different angles and combines them for cross-sectional images of the internal human body. 
4. Ultrasound: An ultrasound checks for kidney and gallbladder infections. The apparatus leverages sound waves and produces real-time images of the internal human body on a monitor.

Treatment:

Here are the various treatment options to get rid of sepsis:

• Medication: If a person is diagnosed with sepsis, they must take antibiotics immediately. The condition can progress rapidly, leading to a septic shock and eventual death. The patient should be given antibiotics within an hour of reaching the hospital. The patient will first be introduced to broad-spectrum antibiotics, which are useful in fighting certain bacteria.

Some medications that a sepsis patient needs to be put on immediately are as follows:

1. Insulin (to bring blood sugar under control)

2. Pain relievers- Buprenorphine (to get rid of discomfort)

3. Intravenous antibiotics- Ceftriaxone, Piperacillin+Tazobactum(to battle the ongoing infection)

4. Vasopressors- Vasopressin(to control the blood pressure)

5. Corticosteroids- Hydrocortisone (to bring down inflammation)

If the sepsis is quite severe, the patient will require a lot of IVs, along with a ventilator or respirator for breathing. Furthermore, if the patient's kidneys are severely affected, they will need dialysis. The dialysis machine will help the human body perform tasks the kidney cannot do, like filtering salt, excess water, and harmful wastes.

Also, keep in mind that antibiotics are vital in helping fight sepsis. However, a patient may develop antibiotic resistance, making it much more difficult to treat the infection.

The side effects of these antibiotics range from mild (nausea, yeast infections, dizziness, rash, etc.) to severe (life-threatening allergic reactions). However, if the patient has sepsis, the risks of antibiotic resistance outweigh the benefits of antibiotic treatment.

• Surgical Treatment: Surgical intervention might be required in the case of severe sepsis. This is in case the doctor wants to surgically remove the source of infection like infected tissues, pus collection, or dead tissues.

Additional Information

Preventing sepsis is possible by following certain proven precautions.

Maintaining Good Hygiene

Sepsis is a condition that can arise due to bacterial, fungal, viral, or parasitic infection. The primary suggestion to avoid such an onslaught is to practice good hygiene habits.

In addition to avoiding contact with infected people, the following steps can prove helpful:

• Hand washing using soap and water

• Regular use of hand sanitiser

• Thorough cleaning of scrapes and wounds

• Taking a bath daily

These generic recommendations can prove crucial in the prevention mechanism.

Regular Vaccination

All infections do not have designated vaccines. Still, reducing the risk of some contaminations is possible due to regular vaccination.

Here are some essential vaccines one can take to prevent sepsis:

• Covid-19

• Hepatitis A

• Pneumonia

• Common flu

• Influenza

In addition, vaccines for yellow fever, smallpox, whooping cough, and rotavirus can help prevent sepsis infection. The immune system reacts to the vaccination by producing antibodies and T-cells. As a result, protection against common diseases can safeguard the body.

Proper Wound Care Routine

Cuts, wounds, or scrapes allow bacteria to enter the body. These intruders can be the main reason for a sepsis infection.

So, cleaning open wounds is one of the most vital prevention tips for sepsis. If a patient has an open wound, the following will help:

• Use clean disposable gloves before touching an open wound

• Connect with the healthcare provider in case of stitches requirement

• Remove the dirt and debris as soon as possible using clean water

• Apply an ointment or antibiotic cream at the earliest

• Identify signs of infection like inflammation, redness, increased pain, and discharge

• Never neglect an open wound, as it can become a primary source of infection.

Take Antibiotics Regularly

This suggestion applies to an ongoing infection. The patient must ensure regular intake of prescription medicines as per the doctor's recommendation. Generally, an effective antibiotic can prevent an ongoing illness. 
Notably, proper storage of medicines proves critical in improving their effectiveness. It is thus vital to use and store antibiotics properly.