Sepsis: MedlinePlus Medical Encyclopedia

Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.

The symptoms of sepsis are not caused by the germs themselves. Instead, chemicals the body releases cause the response.

A bacterial infection anywhere in the body may set off the response that leads to sepsis. Common places where an infection might start include the:

Bloodstream

Bones (common in children)

Bowel (usually seen with

peritonitis

)

Kidneys (upper

urinary tract infection

, pyelonephritis or urosepsis)

Lining of the brain (

meningitis

)

Liver or gallbladder

Lungs (

bacterial pneumonia

)

Skin (

cellulitis

)

For people in or recently discharged from the hospital, common sites of infection include

intravenous

lines, surgical wounds, surgical drains, and sites of skin breakdown, known as bedsores or

pressure ulcers

.

Sepsis most commonly affects infants or older adults.

In a person with sepsis, the blood pressure drops, resulting in

shock

(the inability to provide necessary blood perfusion to all of the organs in the body). Major organs and body systems, including the kidneys, liver, lungs, and central nervous system may stop working properly because of poor blood flow.

A

change in mental status

and very fast breathing may be the earliest signs of sepsis.

In general, symptoms of sepsis can include:

Chills

Confusion

or

delirium

Fever or low body temperature (

hypothermia

)

Lightheadedness due to low blood pressure

Rapid heartbeat

Skin rash

or

mottled skin

Warm skin

A person with sepsis will be admitted to a hospital, usually in the intensive care unit (ICU). Antibiotics are usually given through a vein (intravenously) and need to be given as quickly as possible.

Other medical treatments include:

Oxygen to help with breathing

Fluids given through a vein

Medicines that increase blood pressure

Dialysis

if there is kidney failure

A breathing machine (

mechanical ventilation

) if there is lung failure

Sepsis is often life threatening, especially in people with a weak immune system or a long-term (

chronic

) illness.

Damage caused by a decrease in blood flow to vital organs such as the brain, heart, and kidneys may take time to improve. There may be long-term problems with these organs.

The risk of sepsis can be reduced by getting all recommended vaccines.

In the hospital, careful hand washing can help prevent hospital-acquired infections that lead to sepsis. Prompt removal of urinary catheters and IV lines when they are no longer needed can also help prevent infections that lead to sepsis.

Septicemia; Sepsis syndrome; Systemic inflammatory response syndrome; SIRS; Septic shock

Intensive care unit (ICU)

Gordon AC, Russell JA. Shock syndromes related to sepsis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 94.

Shapiro NI, Jones AE. Sepsis syndrome. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 127.

van der Poll T, Wiersinga WJ. Sepsis and septic shock. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 73.

Updated by: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.