Sepsis Symptoms You Should Never Ignore

When an infection is more than an infection.

Medically reviewed in June 2021

Infections can be bad enough, but if one turns septic it becomes a medical emergency. That was the conclusion the Centers for Disease Control and Prevention (CDC) reinforced in August 2016 after it examined the medical records of 246 adults and 79 children in four New York hospitals. And while healthcare providers are continually making headway in earlier recognition of sepsis signs, the CDC has made a push to get more information about sepsis into the hands of healthcare providers and patients.

“It comes down to training,” says Claudio Fernandez, DO, an emergency medicine doctor with Westside Regional Medical Center in Plantation, Florida. “I’m an ER doctor so I see sepsis a lot.” Doctors in the ER have a lot of experience with sepsis because people who have it are so sick.

What is sepsis?
When the body encounters a foreign substance like a bacteria or virus, it sics the immune system on it. The immune system normally responds by creating enough inflammation to neutralize the foreign substance. But in sepsis, the immune system’s response is so aggressive that it can lead to organ damage and failure.

Diagnosing sepsis
Diagnosing sepsis is complicated, since symptoms may not be apparent until late, when the person is already very ill, or they can resemble other conditions. Healthcare providers use a combination of the person’s medical history, blood work and physical signs, Dr. Fernandez says.

Medical history is important because it can help reveal how the infection started. More than one-third—35 percent—of the sepsis cases in the CDC study started as pneumonia. A quarter developed from urinary tract infections, while 11 percent each came from gut infections and skin infections.

If a healthcare provider thinks someone has sepsis, he or she will calculate a score—called qSOFA, which stands for quick sepsis-related organ failure assessment—to help determine how severe that person’s sepsis is, and how aggressively he or she needs to be treated.  “I’m looking for the vitals,” says Fernandez. “Is the patient feverish? How’s the breathing, is it fast?”

Other qSOFA criteria include low blood pressure or altered mental status, which could be confusion, lethargy, disorientation, strange behavior or even hallucination. A score of two or more, along with a suspected infection source like pneumonia, suggests that a case of sepsis is more severe, with a higher risk of death and other complications.

Other sepsis symptoms include:

  • Shivering, feeling cold or low body temperature
  • Rapid heart beat
  • Decreased urination

A medical emergency
Infants, the very old, and people with weakened immune systems are the most vulnerable to sepsis, but anyone can get it. IV fluids and antibiotics are the mainstays of sepsis treatment.

Treatments like dialysis may be necessary to keep failing organs working. Medications to increase blood pressure may also be needed. Since sepsis develops quickly and in stages, it’s extremely important to recognize the signs and get treated as soon as possible.

“The earlier you recognize sepsis, the earlier you can start treating it,” says Fernandez. Every hour that goes by without antibiotics means a 7.6 percent increase in mortality rate for septic shock, a severe form of sepsis. “The earlier the better,” says Fernandez. “It can make a big difference in a patient.”

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