Sepsis: Causes, Symptoms, Treatment & Sepsis Can Be Cured?

Blood poisoning is a disease caused by an infection or the spread of its toxin through the bloodstream. The presence of bacteria in the blood is called bacteremia. In this article read more about sepsis: causes, symptoms, treatment & sepsis can be cured?

SOS: First aid for blood poisoning

Blood poisoning is considered a medical emergency, is acutely life-threatening and requires medical treatment!

As a first aider, you should therefore

• Dial the emergency number 112 immediately.
• Follow the instructions of the emergency call center.

If the affected person is conscious, you can also do the following:

• Have a calming effect and ensure that the environment is as quiet as possible.
• Check the victim’s consciousness and breathing and feel the pulse.

What is blood poisoning?

Sepsis is a very serious general infection that affects the entire body. Starting from a focus of infection, the body reacts with an inflammation that floods the blood. Triggers can be, for example, a cut, an insect bite, a burn or even pneumonia. The cause is usually bacteria, more rarely viruses, Candida (fungi) or protozoa. However, bacteria in the blood are not always synonymous with sepsis. Only when the body is no longer able to fight the pathogens on its own does blood poisoning occur.

A distinction is made between severe sepsis and septic shock.

Severe sepsis is blood poisoning combined with the failure of an essential system in the body or insufficient blood flow to parts of the body due to infection. Without timely treatment, the entire immune system can collapse.

Severe sepsis requires immediate treatment in the critical care area for a period of one month or more. With timely treatment Sepsis can be cured.

Septic shock is life-threatening low blood pressure caused by blood poisoning. In a toxic septic shock, several organs fail at the same time (multiple organ failure) and the blood pressure drops massively. At this stage, without timely treatment, death occurs in 50 percent of all sepsis cases.

Sepsis can quickly progress to septic shock and death if it’s left untreated. But with timely treatment Sepsis can be cured.

Types of blood poisoning

Sepsis can be caused by bacterial, fungal, and viral infections. Depending on which pathogen is involved or where the original infection is located, different forms of blood poisoning can be distinguished:

Urosepsis: Blood poisoning originating in the urogenital tract (kidneys, ureter, etc.) and mostly caused by toxin-forming bacteria. In 50 percent of cases, these are Escherischia coli (E. coli) bacteria. Sepsis is triggered when the urine flow is disturbed (e.g. due to ureteral stones, ureteral tumors), when germs have penetrated during medical interventions or there is a bacterial infection of the renal pelvis.

Puerperal sepsis: This type of sepsis is also known as childbed or postpartum fever. This is a bacterial infection of the female genital tract during childbirth, which is caused by the penetration of pathogenic germs into the birth wounds.

Neonatal sepsis: In newborns, the immune system is still developing. If the maternal immune protection transmitted by placenta and breast milk is not sufficient in the first month of life, sepsis can occur. The bacterium Streptococcus agalactiae is the most common pathogen. Depending on when the sepsis occurs, a distinction is made between early and late sepsis.

Sepsis in MRSA infection: MRSA (methicillin-resistant Staphylococcus aureus) is a multi-resistant bacterium. If the bacteria get into the bloodstream during an infection, they can trigger sepsis.

Landouzy (sepsis tuberculosa acutissima): Tuberculosis is an infectious disease of the lungs caused by bacteria. The sepsis that occurs as a result of tuberculosis is called Landouzy or sepsis tuberculosa acutissima.

Sepsis in candidiasis: Candidiasis is an infectious disease caused by fungi of the genus Candida. The fungi can attack the mucous membranes of the oral cavity, esophagus and vagina or the entire body (blood, organ systems) (systemic candidiasis). Systemic candidiasis can trigger sepsis.

Viral sepsis: In rare cases, a viral infection can also trigger blood poisoning.

Causes of blood poisoning

The cause of sepsis does not necessarily have to be a wound. In most cases there is an infection with bacteria, more rarely with viruses, fungi or parasites. Normally the body’s immune system fights off the pathogens so that it remains with a limited infection, ie the infection remains confined to its source.

In the case of sepsis, the immune system is not able to do this and the pathogens enter the bloodstream with their toxins, spread in this way and reach other organs. The immune system tries to fight the pathogens with inflammatory reactions and is often unsuccessful. As a result, blood vessel and tissue damage through to organ damage occurs.

In principle, any infection can lead to blood poisoning. In most cases, however, they begin in the lungs, abdomen, or urinary tract. If the original infection includes a collection of pus, the risk of sepsis increases. In some cases such as In toxic shock syndrome, for example, sepsis is triggered by toxins produced by bacteria that never got into the bloodstream.

The decisive factor for the severity of blood poisoning is not the extent of the inflammation at the local focus of infection, but the extent of the loss of control of the immune system. Accordingly, even minor injuries and minor infections can lead to severe blood poisoning.

Possible causes of sepsis and sources of infection are:

• Inflammation of the skin (wound infections)
• Inflammation of the urinary and genital organs (urogenital tract)
• Inflammation of the umbilicus in newborns
• Infections of the ear, nose and throat area, such as tonsillitis, sinusitis or ear infection (otitis)
• inflammation of the intestines
• Inflammation of the bile ducts (cholangitis)
• Inflammation of the heart (infectious endocarditis)

Symptoms of blood poisoning

First symptoms:

• Fever (from 38.5 degrees) or low body temperature (below 36 degrees)
• Chills
• Feeling weak
• Increased breathing and/or heart rate

If sepsis persists:

• Confusion
• Warm and red skin
• Rapid, pounding pulse
• Rapid breathing
• Low blood pressure
• Decreased urination

With progressive sepsis:

• Low body temperature
• Difficult breathing
• Cold, blotchy, or blue skin due to reduced blood circulation
• The reduced blood flow can lead to the death of tissue, including vital organs (e.g. the intestines), and to gangrene.

If septic shock develops, blood pressure remains low despite treatment.

Caution: Blood poisoning cannot be recognized by the well-known red line that leads from a wound to the heart. This is a misconception. It indicates lymphatic inflammation. If left untreated, it can lead to blood poisoning.

Diagnosis of blood poisoning

If there is a suspicion of sepsis, the doctor first carries out a thorough physical examination. To determine the exact pathogen, blood is taken and a blood culture is created. It can take hours or days before the bacterium is identified. During this time, patients receive a broad-spectrum antibiotic.

As soon as the pathogen has been determined, the bacteria can be specifically combated with suitable antibiotics. In addition, the doctor determines the focus of inflammation in the body in order to treat it. The duration of the causal therapy is between seven and ten days.

Course of blood poisoning

Without treatment, blood poisoning gets progressively worse and can be divided into different stages:

Sepsis: The immune system responds to the infection-related inflammation throughout the body. It is characterized by the occurrence of at least two of the following symptoms:

• Fever or hypothermia
• Accelerated heart rate
• Rapid breathing or hyperventilation
• Increased or decreased number of white blood cells (leukocytosis/leukopenia)

Severe sepsis: Blood pressure drops, which changes blood flow and makes it easier for the blood to clot. This results in small blockages in the vessels (thrombi). These ensure that organs no longer receive enough oxygen and are thus damaged in their function, because the cells cannot survive without oxygen and die. In the case of severe sepsis, at least one organ is, by definition, restricted in its function.

Septic shock: If blood pressure remains too low despite treatment and the heart’s pumping power is no longer sufficient to supply the organs with sufficient oxygen, septic shock occurs. This stage is acutely life-threatening. It can lead to circulatory failure and coma, and cause significant damage to multiple organs over the long term. 60% of all those affected do not survive septic shock.

The course and prognosis of blood poisoning depend on how much time elapses before the start of treatment. If blood poisoning is recognized in good time, it can be treated well with antibiotics in most cases. If the blood poisoning was not recognized and treated in time, it can quickly develop into severe sepsis and septic shock and thus become life-threatening.

Blood poisoning can quickly lead to serious complications! Because it spreads through the bloodstream, the infection quickly reaches vital organs. The lungs, heart and liver can be affected within a few hours. As a result:

• Circulatory shock
• Kidney failure
• Lung failure
• Liver failure

Much of intensive care therapy focuses not only on fighting the infection, but also on supporting organ function. Meanwhile, the patient is often placed in an induced coma.

Even if it is possible to combat sepsis, many patients suffer from permanent limitations later on.

Blood poisoning: Consequences

After waking up from an artificial coma lasting several weeks, many patients are initially unable to move. Every single movement of the body has to be learned again, damaged organs have to slowly regain their functionality.

It is not uncommon for limbs to be so severely damaged by the lack of oxygen during sepsis that the tissue dies and has to be surgically removed. This can result in amputation. More frequently, however, long-term consequences of sepsis occur, the causes of which cannot always be clearly determined. These include weight and performance loss, fatigue, headaches, joint and muscle pain, and cognitive disorders.

Some sepsis survivors experience poor concentration, memory loss, deafness, and paralysis. The damage to neurons caused by toxins, drop in blood pressure or the passage of inflammatory substances into the brain during sepsis are probably responsible for this.

After a coma, some patients suffer from post-traumatic stress disorder, which is associated with anxiety, hallucinations and nightmares.

Treatment of blood poisoning

What can the doctor do?

Medication

Drugs that are used in sepsis are intended to kill pathogens in the blood. If bacteria are the culprit, the doctor prescribes antibiotics. Affected patients are first given a broad-spectrum antibiotic, since the exact pathogen is usually not identified at the beginning of treatment.

The broad-spectrum antibiotic is effective against many different strains of bacteria. The antibiotics are usually administered in high doses via an infusion. It is estimated that mortality decreases by up to eight percent for every hour that patients receive the antibiotic earlier.

In the course of treatment, the effect of the drugs used should be reassessed every two to three days. In this way, the therapy is more specifically tailored to specific pathogens and the risk of developing resistance to the antibiotics is reduced.

If the blood poisoning does not improve with treatment with antibiotics, the bloodstream may be infected by fungi of the genus Candida. Then drugs against fungal diseases (so-called antimycotics) are necessary.

Sepsis can be cured – sepsis is curable if it is identified and treated quickly.

Conservative therapy

In the case of severe sepsis or septic shock, the oxygen supply and blood pressure must be sufficiently high before the causal therapy is started. For this purpose, liquid is administered via an infusion (so-called volume therapy). However, if the blood pressure remains too low or the blood flow to the organs is not guaranteed, those affected receive certain hormones, so-called catecholamines (such as noradrenaline, dopamine) to stimulate the cardiovascular system.

The following therapeutic measures may also be necessary:

• Kidney replacement procedures (dialysis, hemofiltration)
• Ventilation
• Replacement of blood cells and substances

In the case of severe sepsis or septic shock, therapy can only be successful if the responsible source of infection (e.g. catheter or wound infection, urinary tract infection or pneumonia) can be completely cured.

In most cases, the focus of infection is surgically removed. The surgeon replaces contaminated implants, opens wounds and removes inflamed or dead tissue. Infected areas are rinsed and the wound secretion is drained off.

If it is unclear where the infection started, imaging methods such as sonography or computer tomography can support the search. Even after the focus has been located, surgery may not be possible because the patient is in very poor condition.

Blood poisoning: ICD code

In medicine, each disease is assigned a specific ICD code. The abbreviation ICD stands for “International Statistical Classification of Diseases and Related Health Problems”. The classification system is recognized worldwide and is one of the most important for medical diagnoses. For example, “bacterial diseases” are recorded under the codes A30-A49. The ICD code A40 stands for “blood poisoning (sepsis) caused by streptococci bacteria”. Entering this code often helps when researching on the Internet.

Prevention of blood poisoning

A good and functioning immune system and rapid treatment of infections can prevent sepsis. The following tips strengthen the immune system and defences:

• Healthy nutrition that supplies the immune system with important nutrients, vitamins, minerals and trace elements
• Sufficient sleep
• Sport and exercise in the fresh air
• Contrast showers
• Avoid overload and pay attention to relaxation, as stress weakens the immune system
• Treat infections quickly
• Immunocompromised people or users of immunosuppressants should seek medical advice as soon as signs of inflammation appear.
• Vaccination against common pathogens (e.g. pneumococci), especially in people whose spleens have been removed.

Blood poisoning: risk groups

There are certain risk factors and risk groups for blood poisoning. Blood poisoning often develops in people who:

• Are very young (e.g. premature babies) or very old
• Due to certain treatments such as B. chemotherapy for cancer or high-dose cortisone therapy for rheumatism or respiratory diseases, only have a weakened immune system
• Have serious internal or external injuries as a result of burns or accidents
• Have to undergo certain treatments and examinations due to serious illnesses (e.g. urinary catheter or wound drainage)
• Tend to develop sepsis due to genetic factors
• e.g. B. dependent on alcohol or other drugs.

Blood poisoning in the elderly

The diagnosis of an infection is often more difficult in older people because fever occurs less frequently in old age or older patients develop a less pronounced temperature increase than young adults. Fever can also be absent in sepsis. Even if it is recognized, the struggle to survive against sepsis is usually not without consequences for older people.

Blood poisoning in children

In the early stages, blood poisoning in children resembles a cold. In most cases, the little ones got the blood poisoning in the hospital. Dangerous hospital germs have an easy time with weakened patients and premature babies are particularly at risk. Blood poisoning can also be the result of an injury or purulent inflammation. You cannot prevent blood poisoning even in children. A wound, no matter how small, should always be disinfected immediately.

Even if a child survives sepsis, chronic organ damage can remain. In the case of very severe cases, amputation sometimes even has to be carried out. Only rapid intensive care and antibiotic treatment can prevent the worst.

The so-called neonatal sepsis occurs mainly in premature babies and in children with a very low birth weight. The cause is an insufficiently developed immunity transmitted by the mother. In neonatal sepsis, a distinction is made between early sepsis and late sepsis.

In early sepsis, the newborn is infected before or during the birth process from mother to child. In most cases, the origin of the germs is the rectum of the mother. From there they travel through the vagina into the uterus. Symptoms are evident within three days of birth.

In the case of late sepsis, the birth canal can be the site of infection. However, the germs can also be transmitted during birth through direct contact with obstetricians. The first symptoms appear after three days at the earliest, but usually only after the first week of life.

Blood poisoning in pregnancy

Women who are pregnant or have recently given birth are at an increased risk of developing sepsis. If it occurs during pregnancy, it is called pregnancy-related sepsis. If blood poisoning occurs within six weeks after childbirth, abortion or miscarriage, it is referred to as postpartum sepsis.

Pregnancy-related sepsis is more common among women aged under 25 and over 40, and women with heart defects, lupus, diabetes, or liver disease. In these cases, the immune system is weakened and the body can no longer fight diseases such as urinary tract infections, flu or pneumonia.

In postpartum sepsis, bacteria enter the mother’s body during childbirth via the vagina or caesarean section and then trigger sepsis.