Blood Poisoning (Sepsis, Septicemia)

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Definition

Blood poisoning is an illness due to an infection or its toxin spreading through the bloodstream. The presence of bacteria in the blood is called bacteremia.

Short bursts of low levels of bacteria in the blood usually do not cause problems. Mild bacteremia typically occurs during a dental cleaning or when brushing your teeth. Your body's immune system fights off these bacteria.

If bacteria persist in the blood they may cause sepsis. This is a serious, life-threatening condition.

Causes

Sepsis occurs when large numbers of infectious agents exist in the blood. Bacteria usually enter the blood from an infection somewhere in the body. Infections with fungi and parasites may lead to sepsis as well. The initial infection could be from any source, but often comes from:

Blood Flow Near Burn Wound

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Sometimes, bacteria may enter the bloodstream directly from an outside source. A dirty needle used by an intravenous (IV) drug user can cause this type of infection. In some cases, the source of the infection is unknown.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include: Recent illness or hospital careFrail health due to extreme age Poorly working immune system due to: Cancer or chemotherapy for treatment of cancer DiabetesAIDS or another immunosuppressive condition such as an autoimmune disease or an immune deficiency Immunosuppressive medications needed after a transplantMedical treatment with an invasive deviceIV drug abuse SymptomsInitial symptoms depend on the site of the infection. For example, with pneumonia you would probably have a cough and shortness of breath. With a urinary tract infection, you would probably have frequent urination and a burning sensation. As the condition progresses to sepsis, symptoms include: Fever and chillsLow temperaturePaleness of skin colorListlessnessChanges in mental statusRapid breathingIncreased heart rateDecreased urine outputLow blood pressureShockProblems with bleeding or clotting DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. If sepsis is suspected, the doctor will try to find the source of the infection. Tests include: Several blood cultures to confirm the diagnosis of sepsisUrine and other blood tests to check for signs of infectionCultures of urine, sputum, stool, and other secretions to check for bacteria or other infectious agentsX-rays a test that uses radiation to take a picture of structures inside the body CT scan a type of x-ray that uses a computer to make pictures of structures inside of the body MRI scan a test that uses magnetic waves to make pictures of structures inside of the body Other specialized tests depending on the source of the infection TreatmentSepsis needs aggressive treatment. Treatment is directed at the cause of the initial infection, if this is identified.
Early treatment improves the chance of survival. Life-saving measures may be needed to stabilize breathing and heart function. Patients usually need monitoring in an intensive care unit. MedicationYou will be given intravenous antibiotics to fight the initial infection and to clear the infectious agent out of your blood. You will be prescribed oral antibiotics to take after leaving the hospital. SurgeryIn addition to antibiotics, surgery is sometimes required to remove or drain the initial infection. Supportive Care You will likely receive other medications, intravenous fluids, and oxygen. Blood transfusions and a respirator (to help you breathe) may be necessary in some cases. Further treatment depends on how your body is responding. For example, you may need kidney dialysis if kidney failure occurs. PreventionIt is not always possible to prevent blood poisoning. Avoiding IV drug abuse decreases your chance of sepsis and other serious infections (hepatitis and AIDS). Healthcare professionals must also take steps to stop the spread of these infections. Getting prompt medical care for infections can reduce your risk of sepsis. RESOURCES: National Center for Infectious Diseases, Centers for Disease Control and Prevention
http://www.cdc.gov/ Society of Critical Care Medicinehttp://www.sccm.org CANADIAN RESOURCES: Communicable Disease Control Unit (Manitoba Health, Public Health Branch)http://www.gov.mb.ca/health/publichealth/cdc/index.html Health Canadahttp://www.hc-sc.gc.ca/index_e.html References: Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000. Conn's Current Therapy 2001 . 53rd ed. WB Saunders Company; 2001. Harrisons Principles of Internal Medicine . 16th ed. McGraw Hill; 2005. Principles and Practice of Infectious Diseases . 5th ed. Churchill Livingstone, Inc.; 2000. Pulmonary & Critical Care Medicine . 1998 ed. Mosby-Year Book, Inc.; 1998. Last reviewed March 2008 by Mark A. Best, MD, MPH, MBAPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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