Sepsis: How can a minor infection become life-threatening?

Do you have a wound on your body that is getting a little infected? Or are you struggling with something like a small lung infection or a urinary tract infection? We usually think that these things will go away with a little rest and some medicine. But sometimes, unexpectedly, such a minor infection can develop into a serious condition that affects the whole body and is life-threatening. That dangerous condition is called "sepsis."

Simply put, what is sepsis?

Imagine that there is an army protecting our country. When an enemy comes from outside, this army goes and fights that enemy, defeats them, and saves the country. Our body's immune system is like this army. When a germ, such as a bacteria or virus, enters the body, our immune system is activated and fights that germ, saving us from diseases.

But, imagine what kind of devastation would result if something suddenly went wrong, our own army stopped fighting the enemy, and started destroying homes and cities in our own country?

Sepsis is something like that.

When an infection occurs, sometimes our body's immune system goes out of control. It stops fighting the infection and starts attacking our own healthy tissues and organs. This causes inflammation throughout the body.

At the same time, an abnormal chain reaction begins in the blood clotting system, and blood clots begin to form unnecessarily inside the blood vessels. This reduces blood flow to major organs such as the brain, heart, kidneys, and lungs. When these organs are deprived of oxygen and nutrition, they can become seriously damaged, malfunction, and eventually even die.

Are there stages of sepsis?

In the past, doctors divided sepsis into three stages: sepsis, severe sepsis, and septic shock.

But now, we see this as a progressive condition. That is, it can start with a simple infection, progress to bacteremia, then sepsis, and finally septic shock, which can lead to organ failure and death.

Who is at higher risk of developing sepsis?

Although sepsis can affect anyone, some people are at higher risk. This is especially true for people who have an infection or blood-borne infection. The following people are also at higher risk:

What are the symptoms of sepsis?

Because sepsis affects many parts of the body, there can be many symptoms. One or more of these may occur at the same time. It is important to be aware of these symptoms, as early recognition can save a life.

• Fever or low body temperature: The body can get a fever. And sometimes the body temperature can drop much lower than normal (hypothermia).
• Shivering and feeling cold: You may feel a tingling sensation in your body.
• Heart palpitations: The heart starts beating faster than it feels.
• Increased breathing rate: Breathing becomes rapid, and may feel like panting.
• Confusion and agitation: Feeling dizzy, losing consciousness, acting agitated. Even speech may become slurred.
• Low blood pressure: Blood pressure (BP) can drop suddenly.
• Severe pain: You may feel unbearable pain or discomfort in your body.
• Skin changes: Sometimes red or discolored spots on the skin (sepsis rash) may appear. The skin may also become warm or clammy with sweat.
• Decreased urination: The amount of urine you pass is much less than normal.
• Feeling of weakness: feeling extremely tired and weak.

What are the main causes of sepsis?

The main cause of sepsis is bacterial infection . However, sometimes fungal, parasitic, and viral infections can also cause sepsis. The important thing is that no matter where the infection is, the body's response to it is an uncontrolled chain reaction that leads to sepsis.

These are the most common places where the infection can start:

Respiratory system

• Lung infections, especially conditions like pneumonia.

Urinary system

• Urinary tract infections. This risk is especially high for people with urinary catheters.

Gastrointestinal system

• Appendicitis.
• Intestinal problems.
• Infections in the abdominal cavity (Peritonitis).
• Liver or gallbladder infections.

Central nervous system

• Infections of the brain or spinal cord (e.g. meningitis).

Skin

• Bacteria enter the body through wounds, cuts, or through insertion sites such as saline cannulas.
• Skin infections such as cellulitis.

Is sepsis contagious?

No. Sepsis itself is not contagious. You will not get sepsis if you touch or are near someone who has sepsis.

However, the infection that causes sepsis can sometimes be contagious. For example, if it's a respiratory infection like pneumonia, the germs that cause the infection can be passed on to someone else.

How does a doctor know for sure if you have sepsis?

There is no single definitive test to diagnose sepsis, so doctors use a combination of information from patient exams, laboratory tests, and X-rays to confirm the condition.

If a doctor suspects sepsis upon admission to the hospital, they will perform a rapid assessment. This is done using a method called ``(qSOFA)``. Sepsis is suspected if a person with suspected infection has two or more of the following symptoms:

• Low blood pressure: Systolic pressure (the top number) falls below 100 mmHg.
• Increased respiratory rate: Breathing more than 22 times per minute.
• Confusion/Consciousness: A score of 15 or less on the Glasgow Coma Scale, which measures the patient's level of consciousness.

After this initial suspicion, several more tests are performed to determine exactly what the infection is and whether any organs have been damaged.

• Blood tests: Complete Blood Count (CBC), blood cultures, liver and kidney function, and blood clotting problems.
• Blood oxygen level: A clip-like device is attached to the finger to measure how much oxygen is in the blood.
• Urine tests: Check for urinary tract infections.
• Other scans: A chest X-ray or CT scan may be done.

How is sepsis treated?

Treatment for sepsis must begin immediately . The sooner the diagnosis is made and the sooner treatment begins, the greater the chance of saving a life.

Typically, a patient diagnosed with sepsis is admitted to the hospital's Intensive Care Unit (ICU) for specialized treatment.

• Antibiotics: If it is a bacterial infection, appropriate strong antibiotics will be started immediately through a vein (intravenous - IV).
• Intravenous fluids (IV fluids): Large amounts of fluids, such as saline, are given to maintain good blood flow to the organs and prevent a drop in BP.
• Blood pressure control medications (Vasopressors): If saline is given but BP cannot be brought to an adequate level, vasopressor medications are given that increase BP by constricting blood vessels.
• Organ support: If an organ is failing, it is given supportive care. For example, if the kidneys are failing, dialysis may be required. If breathing is difficult, mechanical ventilation may be required.
• Surgery: If the cause of the infection is something like a festering wound or an abdominal infection, the damaged tissue will need to be surgically removed.

What happens after you recover from sepsis?

If the disease is diagnosed and treated quickly, most people with sepsis will recover completely. However, if the condition becomes severe, especially if it progresses to septic shock, it can be difficult to save a life even with treatment. In septic shock, death can occur within as little as 12 hours.

Even if sepsis is life-saving, some people may experience long-term effects.

• Insomnia, nightmares.
• Panic attacks.
• Pain in joints and muscles.
• Decreased ability to think, remember, and make decisions.
• Long-term impairment of the function of an organ.

Also, someone who has had sepsis once is at risk of developing it again. Therefore, if a new infection occurs, it is very important to seek treatment immediately.

The journey to recovery... after returning home

After you recover from sepsis and return home, you need to give your body and mind time to recover. At first, you may experience discomfort such as:

Physical difficulties:

• Extreme fatigue and weakness.
• Difficulty breathing.
• Body pain.
• Difficulty walking, performing tasks, and sleeping problems.
• Loss of appetite and weight loss.
• Dry skin, itching, brittle nails, and hair loss.

Mental and emotional difficulties:

• Willingness to be alone.
• Flashbacks.
• Difficulty concentrating.
• Anxiety and Depression.
• Quick to anger, frustration.
• Confusion.

Get as much rest as you can during this time. Follow your doctor's instructions. At first, try to set small goals, such as bathing and getting dressed, and then work on them. Talk to family and friends about your feelings. This journey will take some time, but you will gradually get back to normal.

How to protect yourself from sepsis?

The best way to avoid sepsis is to prevent infections from occurring and to seek prompt treatment if infections do occur.

• Good hygiene: Wash your hands thoroughly with soap and water regularly.
• Keeping wounds clean: Clean wounds such as cuts and scrapes thoroughly and keep them covered until they heal.
• Getting Vaccinations: Get all required vaccinations on time.
• Chronic disease management: If you have diseases like diabetes, manage them well.
• Seek immediate medical advice:

If you suspect you have an infection, if it doesn't go away, or if it seems to be getting worse, see a doctor without delay. An infection that is ignored as a minor issue can be life-threatening.