Sepsis can affect your mental status. Some people, especially the elderly, may not show typical signs of infection. Instead, they may show a sudden change in mental status, becoming confused, or a worsening of dementia and confusion. Sleepiness, often severe, is also a common complaint.
Sepsis can develop quickly from initial infection and progress to septic shock in as little as 12 to 24 hours.1 You may have an infection that's not improving or you could even be sick without realizing it.
It's clear that sepsis doesn't occur without an infection in your body, but it is possible that someone develops sepsis without realizing they had an infection in the first place. And sometimes, doctors never discover what the initial infection was.
Sepsis is known as the 'silent killer' because its symptoms often mimic that of other illnesses such as the flu or gastro. But, if it is identified and treated early, patients can recover.
a high temperature (fever) or low body temperature. a change in mental state – like confusion or disorientation. slurred speech. cold, clammy and pale or mottled skin.
The early symptoms of sepsis include: a high temperature (fever) or, due to changes in circulation, a low body temperature instead. chills and shivering.
If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc. Sometimes however, you may have an infection and not know it, and not have any symptoms.
Most people make a full recovery from sepsis. But it can take time. You might continue to have physical and emotional symptoms. These can last for months, or even years, after you had sepsis.
As sepsis worsens or septic shock develops, an early sign, particularly in older people or the very young, may be confusion or decreased alertness. Blood pressure decreases, yet the skin is paradoxically warm. Later, extremities become cool and pale, with peripheral cyanosis and mottling.
Unlike diseases or conditions like diabetes or kidney stones, there is no one test for sepsis testing. However, your doctor makes the diagnosis by evaluating your symptoms, your history, and other tests. This can then lead your doctor to suspect you have sepsis.
A single diagnostic test for sepsis does not yet exist, and so doctors and healthcare professionals use a combination of tests and immediate and worrisome clinical signs, which include the following: The presence of an infection. Very low blood pressure and high heart rate. Increased breathing rate.
This can cause vital organs to shut down. This usually starts with the kidneys. Blood pressure can drop dangerously low. This can cause less oxygen and nutrients to reach your kidneys.
Sepsis may cause atypical blood clotting. The resulting small clots or burst blood vessels may damage or destroy tissues. Most people recover from mild sepsis, but the mortality rate for septic shock is about 30% to 40%. Also, an episode of severe sepsis raises the risk for future infections.
With quick diagnosis and treatment, many people with mild sepsis survive. Without treatment, most people with more serious stages of sepsis will die. Even with treatment, 30% to 40% of people with septic shock, the most severe stage of sepsis, will die.
It's known that many patients die in the months and years after sepsis. But no one has known if this increased risk of death (in the 30 days to 2 years after sepsis) is because of sepsis itself, or because of the pre-existing health conditions the patient had before acquiring the complication.
People are more likely to develop sepsis in the community than in the hospital – up to 87% of cases start from infections people contracted at work, school, or home. Sepsis can start gradually, or the symptoms can come on very suddenly.
Septic shock death timeline
Clinically identified cases of septic shock are more likely to pass away within 28 days than undiagnosed cases. Within the first week of diagnosis, sepsis that progresses to severe sepsis or septic shock increases the risk of death.
For example, the “golden hour” as applied to the treatment of critically children and adults with severe sepsis and septic shock is based upon early recognition, early administration of antibiotics, and early reversal of the shock state.
Many conditions mimic sepsis by meeting criteria for SIRS.
These conditions include: pulmonary embolism (PE), adrenal insufficiency, diabetic ketoacidosis (DKA), pancreatitis, anaphylaxis, bowel obstruction, hypovolemia, colitis, vasculitis, toxin ingestion/overdose/withdrawal, and medication effect.
Symptoms and Signs
Some patients are asymptomatic or have only mild fever. Development of symptoms such as tachypnea, shaking chills, persistent fever, altered sensorium, hypotension, and GI symptoms (abdominal pain, nausea, vomiting, diarrhea) suggests sepsis or septic shock.
Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
CBC, bilirubin, and creatinine tests are also used in calculating SOFA scores and may help identify patients with sepsis. Singer M, Deutschman CS, Seymour CWarren, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA.
“But the most common cause of sepsis is community–acquired pneumonia,” Angus says. Scientists are still working to understand why some people with infections develop severe sepsis or septic shock while others don't. Researchers are exploring new ways to diagnose, reverse, or prevent this serious and costly condition.
Some of the most frequently isolated bacteria in sepsis are Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Klebsiella spp., Escherichia coli (E. coli), and Pseudomonas aeruginosa (P.