Zhidkov and Klechikoff - ICU (ZA), and
UPenn, Med C.

Alternative names:
gram-negative bacteremia; gram-positive bacteremia

A serious infection caused by bacteria that has entered a or body tissue that leads to the formation of pus, or to the spread of the bacteria in the blood

Causes, incidence, and risk factors:
Sepsis is a result of a bacterial infection that can originate anywhere in the body. Common sites are the genitourinary tract, the liver or biliary (liver secretion) tract, the gastrointestinal tract, and the lungs. Less common sites are intravenous lines, surgical wounds, surgical drains, and sites of skin breakdown known as decubitus ulcers or bedsores. The infection is usually confirmed by a positive blood culture. The infection can lead to shock, called septic shock. Low blood pressure and a change in mental status may be early-warning signs of shock.

There has recently been an increase in the occurance of sepsis caused by organisms that are resistant to most standard antibiotics.

Sepsis can be a life-threatening situation, especially in people with a weakened immune systems. The risk factors associated with sepsis include:
  • recent bacterial pneumonia
  • meningitis
  • a urinary tract infection that does not respond to antibiotics
  • osteomyelitis
  • bacterial peritonitis
  • a recent dental procedure
  • a recent endoscopy procedure
  • a recent therapy with antibiotics
People whose immune systems are suppressed by therapies or by certain diseases are at higher risk for sepsis. The incidence is 2 out of 10,000 people.


Additional symptoms that may be associated with this disease:
  • red skin spots
  • joint pain
  • hallucinations
  • hypotonia
  • white blood cell count that is low or high
  • blood culture that is positive for bacteria
  • blood gases that reveal acidosis
  • urine pH that may be low
This disease may also alter the results of the following tests:
  • RBC indices
  • peripheral smear
  • fibrin degradation products
  • cholesterol test
  • blood differential

Hospitalization is necessary to achieve treatment goals. Intravenous antibiotic therapy should be initiated as soon as the diagnosis is suspected. The therapy is not delayed while determining the causative organism. Sometimes more than one type of antibiotic is given while results of the blood cultures are pending. Antibiotics can then be changed when the culture results are available and the causative organism is known. The source of the infection should be identified if possible, which may mean further diagnostic testing. Sources such as infected intravenous lines or surgical drains can be removed, and sources such as abscesses can be surgically drained. Supportive therapy with oxygen and intravenous fluid and management of complications is important for a good outcome.

Expectations (prognosis):
The death rate can be as high as 60% for people with severely low white blood cell counts or suppressed immune systems. In people with no underlying disease, the death rate is about 5%.

  • septic shock
  • impaired blood flow to vital organs (brain, heart, kidneys)
  • disseminated intravascular coagulation

Many cases are not preventable. Awareness of risk may allow earlier detection.

Sep"sis (?), n. [NL., fr. Gr. putrefaction.] Med.

The poisoning of the system by the introduction of putrescent material into the blood.


© Webster 1913.

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