Sepsis

Sepsis is a life-threatening reaction to an infection. Get immediate medical help if anyone has the symptoms below. Sepsis can quickly cause multiple organ failure and death, so time matters. You may hear sepsis being called septicaemia. Medically, septicaemia is an infection of your blood, whereas sepsis is your body’s exaggerated response to infection. But they are basically the same serious, life-threatening condition.

Sepsis requires immediate medical attention. Time matters. 

Seek immediate medical help if you or the person you are caring for has any of the symptoms of sepsis described below: 

  • slurred speech or confusion
  • extreme shivering or muscle pain
  • passing no urine (pee/mimi) for a day
  • severe breathlessness
  • it feels like you are going to die
  • skin mottled or discoloured.

Ask 'Could this be sepsis?'

Call Healthline free on 0800 611 116 if you are unsure what to do. 

Key points

  1. Infections that lead to sepsis can occur at any age, but it is more common in infants, older adults and people who have weakened immune systems.
  2. Sepsis requires immediate medical attention. If not treated quickly, sepsis can rapidly lead to multiple organ failure and death. If you or the person you are caring for is at risk of sepsis and is unwell, get immediate medical help.
  3. Sepsis is your body's response to infection, so by treating any infection seriously, you will reduce your chances of developing sepsis.
  4. Millions of people around the world die of sepsis every year – most of these deaths are preventable. Many people who survive sepsis suffer from consequences of it for the rest of their lives.

What causes sepsis?

Infections are usually confined to one area of your body such as lungs, urinary tract or skin. In most cases, your body’s immune system is able to fight off the infection. However, sometimes the combination of the infecting organism and your immune system's response to it can lead to damage to your body’s organs and tissues.

Sepsis can lead to a drop in blood pressure which leads to your circulatory system being unable to provide enough oxygen and nutrients to the rest of your body. This leads to damage to various organs such as your lungs, heart, kidneys and brain. Multiple organ failure and death can result, especially if sepsis is not diagnosed early and treated quickly. Sepsis is an emergency. 

Who is at risk of getting sepsis?

Sepsis can occur at any age, but you are at increased risk if you have a serious infection or a weakened immune  system, eg, if you:

  • are very young or very old
  • are taking steroids long term or medicines to treat cancer (chemotherapy)
  • have had an organ transplant and are on anti-rejection medicines
  • have a long-standing (chronic) disease such as diabetes, chronic obstructive pulmonary disease (COPD) or kidney disease
  • have severe liver disease
  • have HIV or leukaemia
  • have recently had surgery
  • have wounds or injuries as a result of an accident 
  • have drips or catheters attached to your skin
  • are pregnant or have just given birth.

Sepsis is a particular risk for people already in hospital because of another serious illness.

Sepsis and cancer

Having cancer and certain treatments for cancer can put you at higher risk of developing an infection and, as a result, sepsis. This is because your body may not be able to fight off infections as it normally would.

  • Although an infection can happen at any time, your risk of getting an infection is especially increased when you have very low levels of a certain type of white blood cell called neutrophils. This is known as neutropaenia.  
  • Your doctor will routinely test for neutropaenia by checking the level of your white blood cells (neutrophils). Read more about cancer, sepsis and infection

Sepsis and pregnancy (also called maternal sepsis)

If sepsis develops during pregnancy, during or after giving birth, or after an abortion, it is called maternal sepsis. It is one of the main causes of maternal death. If you feel unwell at any time during your pregnancy, consult your healthcare provider.

Prevention is key to reducing your risk of getting sepsis. Make sure you attend recommended antenatal visits, where healthcare providers will:

  • screen you for common infections
  • advise you on how to prevent infections 
  • provide information on vaccinations and nutrition
  • prescribe treatments to prevent or treat bugs that may lead to infection in you or your baby.

The risk of having an infection after a Caesarean section is 4 times higher than by vaginal birth. This is mainly related to the risk of developing an infection at the site of the wound. Seek immediate medical attention if you have any of the following within 14 days after giving birth:

  • fever
  • an open wound or pus 
  • painful, red, swollen breasts with fever
  • bad smelling discharge or pus from your vagina 
  • severe abdominal (tummy) pain
  • pain when urinating (peeing) plus feeling unwell and having a fever.

Read more about maternal sepsis

What are the symptoms of sepsis?

Symptoms of worsening infection require immediate medical attention. Time matters. If not treated quickly, sepsis can quickly lead to multiple organ failure and death.

Usually, the first symptoms are those associated with the source of infection, such as a cough due to pneumonia (lung infection) or tummy pain from appendicitis.

Symptoms that indicate an infection is getting worse include:

  • fever and chills, waves of hot and cold
  • feeling very unwell
  • fast breathing
  • passing less urine (pee) than usual
  • dizziness, or changes in mental alertness such as confusion, drowsiness or disorientation.


Image source: Have an infection? Just ask "could it be sepsis?" Sepsis Trust, NZ

Call Healthline free on 0800 611 116 if you are unsure what to do. Ask 'Could this be sepsis?'

How is sepsis treated?

Treatment of sepsis depends on the site and cause of the infection, the organs affected and the extent of any damage. Treatment involves taking antibiotics (if the infection is detected early enough this may be a course of tablets you can finish taking at home) and often intravenous fluids and sometimes oxygen.

What is septic shock?

When sepsis is severe, you develop septic shock. This is when your blood pressure drops to a dangerously low level. This carries the highest risk of death and complications. Sepsis, especially if severe, needs urgent hospital treatment and may require admission to an intensive care unit (ICU). ICUs are able to support many affected body functions, such as breathing or blood circulation.

Can sepsis be prevented?

Sepsis is as a result of an infection, so by treating any infection seriously, you will decrease the chances of developing sepsis. This means seeking early treatment and taking antibiotics when prescribed. You can also prevent infections by:

  • frequent and thorough hand washing
  • getting vaccinated for the seasonal flu each year
  • coughing into your elbow, not your hand (to help prevent spreading infection if you are sick) 
  • maintaining a healthy lifestyle with nutritious food, exercise and plenty of sleep.

Learn more

The following links have more information about sepsis. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

What is sepsis? Sepsis Trust NZ
Sepsis
Centers for Disease Control and Prevention, US
Sepsis NHS Choices, UK 
Sepsis – FAQ World Sepsis Day 

References

  1. Sepsis care and treatment in New Zealand and Australia Journal of Emergency Medicine, 2017 
  2. Infection and antibiotic use following major surgery HQSC, NZ
  3. Patient deterioration and sepsis HQSC, NZ
Credits: Health Navigator Editorial Team. Reviewed By: Dr Osman David Mansoor, Medical Officer of Health, Hawke’s Bay DHB and Dr Andrew Burns, infectious disease physician, Hawke’s Bay DHB Last reviewed: 16 Feb 2018