User:Mr. Ibrahem/Sepsis
Medical condition / From Wikipedia, the free encyclopedia
Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its tissues and organs.[5] This initial stage is followed by suppression of the immune system.[9] Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion.[2] There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection.[3] The very young, old, and people with a weakened immune system may have no symptoms of a specific infection, and the body temperature may be low or normal instead of having a fever.[3] Severe sepsis is sepsis causing poor organ function or blood flow.[10] The presence of low blood pressure, high blood lactate, or low urine output may suggest poor blood flow.[10] Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement.[10]
Sepsis | |
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Other names | Septicemia, blood poisoning |
Blood culture bottles: orange cap for anaerobes, green cap for aerobes, and yellow cap for blood samples from children[1] | |
Pronunciation | |
Specialty | Infectious disease |
Symptoms | Fever, increased heart rate, low blood pressure, increased breathing rate, confusion[2] |
Causes | Immune response triggered by an infection[3][4] |
Risk factors | Young or old age, cancer, diabetes, major trauma, burns[2] |
Diagnostic method | Systemic inflammatory response syndrome (SIRS),[3] qSOFA[5] |
Treatment | Intravenous fluids, antimicrobials[2][6] |
Prognosis | 10 to 80% risk of death[5][7] |
Frequency | 0.2–3 per 1000 a year (developed world)[7][8] |
Sepsis is an inflammatory immune response triggered by an infection.[3][4] Bacterial infections are the most common cause, but fungal, viral, and protozoan infections can also lead to sepsis.[3] Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs.[3] Risk factors include being very young, older age, a weakened immune system from conditions such as cancer or diabetes, major trauma, or burns.[2] Previously, a sepsis diagnosis required the presence of at least two systemic inflammatory response syndrome (SIRS) criteria in the setting of presumed infection.[3] In 2016, a shortened sequential organ failure assessment score (SOFA score), known as the quick SOFA score (qSOFA), replaced the SIRS system of diagnosis.[5] qSOFA criteria for sepsis include at least two of the following three: increased breathing rate, change in the level of consciousness, and low blood pressure.[5] Sepsis guidelines recommend obtaining blood cultures before starting antibiotics; however, the diagnosis does not require the blood to be infected.[3] Medical imaging is helpful when looking for the possible location of the infection.[10] Other potential causes of similar signs and symptoms include anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism.[3]
Sepsis requires immediate treatment with intravenous fluids and antimicrobials.[2][6] Ongoing care often continues in an intensive care unit.[2] If an adequate trial of fluid replacement is not enough to maintain blood pressure, then the use of medications that raise blood pressure becomes necessary.[2] Mechanical ventilation and dialysis may be needed to support the function of the lungs and kidneys, respectively.[2] A central venous catheter and an arterial catheter may be placed for access to the bloodstream and to guide treatment.[10] Other helpful measurements include cardiac output and superior vena cava oxygen saturation.[10] People with sepsis need preventive measures for deep vein thrombosis, stress ulcers, and pressure ulcers unless other conditions prevent such interventions.[10] Some people might benefit from tight control of blood sugar levels with insulin.[10] The use of corticosteroids is controversial, with some reviews finding benefit,[11][12] and others not.[13]
Disease severity partly determines the outcome.[7] The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and septic shock 80%.[7] Sepsis affected about 49 million people in 2017, with 11 million deaths (1 in 5 deaths worldwide).[14] In the developed world, approximately 0.2 to 3 people per 1000 are affected by sepsis yearly, resulting in about a million cases per year in the United States.[7][8] Rates of disease have been increasing.[10] Sepsis is more common among males than females.[3] Descriptions of sepsis date back to the time of Hippocrates.[15] The terms "septicemia" and "blood poisoning" have been used in various ways and are no longer recommended.[15][16]