What is Sepsis or Septic Shock?

Sepsis, also called sepsis or septicemia, is a syndrome that occurs in patients with severe infections, characterized by an intense inflammatory condition throughout the body. Sepsis is triggered by the bloodstream invasion by infectious agents like bacteria or viruses, therefore, is commonly called the lay public infection of the blood.


What is sepsis

Easily, sepsis is a disease that occurs when germs, mainly bacteria invade the bloodstream and cause an intense inflammatory response throughout the body.

We will elaborate on this explanation:

Every time our body is invaded by microorganisms, our immune system is activated so we can fight the invading agent. One of the ways used by our defense cells to attack invaders is through the release of chemical mediators that cause an inflammatory response. The inflammation that arises in infected sites is not caused by the bacterium itself, but by the body's immune response. Create an inflammatory process is a form of defense. The redness, pain, heat and pus, characteristic of infected wounds are the result of the battle between the immune system and the invading germs.

Generally, infections start at specific sites of the body such as the skin, lungs, urinary tract, ear, etc.

Examples of bacterial infections located in a specific part of the body:
  • Pneumonia lung infection
  • Cystitis bladder infection
  • Otitis ear infection
  • Erysipelas = skin infection
  • Meningitis infection of the meninges and the nervous system

At first, the bacteria are housed in an organ such as the lung, for example, and are fought by our defense mechanisms. If the infection is not controlled, these bacteria multiply and begin to migrate en masse to other points, reaching a vase and have full access to the bloodstream. Small amounts of bacteria in the blood may fall in trivial situations, such as during a brushing of teeth that causes bleeding gums or when ralamos the knee. Few bacteria in the blood are rapidly inactivated and controlled by the immune system.

The problem arises when large amounts of bacteria arrive en masse into the bloodstream, spreading throughout the body. As defense cells need to act on several points at the same time to fight the infection, they end up unleashing a diffuse inflammatory process. Everyone has had an inflammation, either in the tooth, skin or any other part of the body. Imagine this process occurring internally and simultaneously in several blood vessels and organs. It's like a war going on inside your body. There are deaths on both sides and a lot of destruction of surrounding structures. This is sepsis.

There are degrees of severity of sepsis. Some bacteria are more virulent than others and each body has a greater or lesser ability to deal with invaders, causing more or less inflammation. Healthy patients with infections caused by bacteria usually less aggressive and control their infections, not progressing to more severe of sepsis.

What are the consequences of severe sepsis?

The diffuse inflammatory process of severe sepsis causes a dilation of blood vessels, causing a drop in blood pressure, which in severe cases can lead to a state of circulatory shock (called septic shock ). The inflammatory chemical mediators also cause an increased permeability of blood vessels, thus facilitating the leakage of fluids to organs such as lungs and skin. The septic patient can get all swollen ( puffy ) and water in the lungs.

These changes in the permeability of blood vessels and blood pressure cause a reduction in the supply of oxygen and nutrients to the tissues, leading to hypoxia ( lack of oxygen ) and bankrupt them. The coagulation system may also be affected. One of the most dramatic events of sepsis is disseminated intravascular coagulation (DIC ), a process in which the system is uncontrolled coagulation, thrombosis and bleeding occurring simultaneously.

When sepsis is severe, the kidneys and liver stop working, the heart becomes weaker, the brain malfunctions and lungs are filled with water. The patient may then present the dreaded multiple organ failure.

The more severe sepsis, the greater the risk of death. Severe sepsis comes to have greater than 50% mortality, even with medical treatment.

Symptoms of sepsis

Any infection can lead to sepsis. Many of you have probably had an early stage sepsis m. To characterize a sepsis infection simply show 2 more of the 4 signs and symptoms described below:
  • Body temperature greater than 38°C or less than 35°C.
  • Heart rate greater than 90 beats per minute.
  • Respiratory rate greater than 20 breaths per minute.
  • In CBC: WBC above 12,000 or below 4000 cells/mm3.

In fact, until a stronger flu can cause the patient presents criteria for sepsis. Have criteria for sepsis does not mean that the patient is very serious and it will die. These criteria are warning signs for doctors, indicating that the patient should be treated well so that the framework does not evolve. You can have tonsillitis and have criteria for sepsis. But just treat the infection properly that most people will recover. However, if the patient is negligent and not seek medical attention, infection, which was initially restricted to the neck, can spread through the blood and become more difficult to control. One can turn a bland sepsis severe sepsis.

A patient with a box of infection with high fever and chills, which gets more tired, more prostrate, lose appetite and can not get out of bed, presents a very characteristic clinical picture of sepsis. Elderly patients with sepsis may not have fever, but often have great prostration, disorientation and confusion. Medical evaluation and treatment with antibiotics is important to prevent the box evolve catastrophically.

Those with severe sepsis is considered:
  • Hypotension and circulatory shock.
  • Worsening of kidney function.
  • Fall in platelet count.
  • Amendment of consciousness.
  • Difficulty breathing.
  • Coagulation disorders.
  • Decreased heart function.

Sepsis is contagious?

No. Sepsis is not a particular infection that can be transmitted from one person to another. Sepsis is the aggravation of a previously established infection. Is a urinary tract infection, otitis media, pneumonia, etc., Which is evolving in a dangerous way and spread through the body.

Logically, if the cause of sepsis is a contagious disease, such as meningitis, for example, have contact with the patient can be dangerous.

Treatment of sepsis and septic shock

The treatment of sepsis should be initiated as soon as possible. The larger and more diffuse systemic inflammation is, the lower is the therapeutic response and higher mortality. The severity of the infection, another important prognostic factor is the patient's ability to fight infection.

Are of poor prognosis in sepsis and septic shock:

The initial sepsis treatment is with antibiotics to eliminate the bacteria and stop the factor stimulating the inflammatory process. If there are signs of a drop in blood pressure, is essential for the immediate replacement of fluids intravenously to reverse hypotension. The sooner treatment is initiated against sepsis, the greater the chance of success.

In cases of shock may be necessary medications to stabilize blood pressure. Many patients develop respiratory and / or renal failure requiring mechanical and / or hemodialysis ventilation. The more organs stop functioning, the greater the risk of progression to death. Therefore, patients requiring breathing apparatus, hemodialysis, drugs to control blood pressure, etc. at high risk of death.

Patients with severe sepsis or septic shock should be treated preferentially in a intensive care unit - ICU.

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