Observable signs that a provider may notice while assessing a septic patient include poor skin turgor, foul odors, vomiting, inflammation and neurological deficits.
Patients with atypical symptoms, such as a general decline in health status, inability to perform activities of daily living, change in mental status, or incontinence, are more likely to have increased mortality rates from sepsis.
PCT and CRP are both proteins produced in response to infection and/or inflammation. They are probably the two most widely used clinical tests to diagnose and manage patients with sepsis, with the exception of lactate. CRP is a well-established biomarker of infection and inflammation29.
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.
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.
People with sepsis often develop a hemorrhagic rash—a cluster of tiny blood spots that look like pinpricks in the skin. If untreated, these gradually get bigger and begin to look like fresh bruises. These bruises then join together to form larger areas of purple skin damage and discoloration.
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 happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract.
Organ failure, including kidney failure, is a hallmark of sepsis. As the body is overwhelmed, its organs begin to shut down, causing even more problems. The kidneys are often among the first to be affected.
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.
The condition can arise suddenly and progress quickly, and it's often hard to recognize. Sepsis was once commonly known as “blood poisoning.” It was almost always deadly. Today, even with early treatment, sepsis kills about 1 in 5 affected people.
Sepsis patients typically present with symptoms of infection and organ dysfunction. Some symptoms of sepsis are easy to identify, such as fever and chills, productive cough, or dysuria. However, in some patients, particularly the elderly or immunocompromised, these symptoms might be vague or atypical.
Blood tests may reveal the following signs suggestive of sepsis: Elevated or low white blood cells – Higher than usual levels of leukocytes, known as white blood cells (WBCs), are a sign of a current infection, while too few WBCs indicate that a person is at higher risk of developing one.
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.
However, there might be other symptoms related to sepsis based on where the infection is. Abdominal pain is one such symptom.
Blood culture: A blood culture test tries to identify what type of bacteria or fungi caused infection in the blood. Blood cultures are collected separately from other blood tests. They are usually taken more than once from different veins. It can take several days to get the results of a blood culture.
The CBC of a patient with sepsis is commonly characterized by lymphocytopenia, neutrophilia, eosinopenia, thrombocytopenia, increased RDW, and increased NLR (Figure 2). The importance of thrombocytopenia in patients with sepsis is emphasized by the inclusion of platelet count in the SOFA score.
Procalcitonin (PCT)
PCT, the precursor of the hormone calcitonin, is elevated in patients with invasive bacterial infections. It is produced by many tissues, not just cells at the local site of infection, and is part of the systemic response in severe sepsis.
Quick treatment can prevent sepsis
Other symptoms may include: Cloudy, bloody, or foul-smelling urine. Pain or burning during urination. Strong and frequent need to urinate, even right after emptying the bladder.
NICE - the National Institute for Health and Care Excellence - urges hospital staff to treat people with life-threatening sepsis within one hour, in its quality standard. In clinical practice, this is often referred to as the 'golden hour' after diagnosis.
Most sepsis is caused by bacterial infections, but it can also be caused by viral infections, such as COVID-19 or influenza; fungal infections; or noninfectious insults, such as traumatic injury.