1, 3, 4, 5, 6<\/strong>)<\/sup>.<\/p>\nConversely, septicemia is when an infection occurs in the blood. This may or may not be due to bacteremia. Further, septicemia can also be caused by other organisms such as fungus.<\/p>\n
Septicemia Vs Sepsis<\/h2>\n
Sepsis is actually a clinical syndrome with a wide range of abnormalities such as biochemical and physiological conditions that occurs due to a dysregulated immune response of our body to an infection.<\/p>\n
The definition of sepsis had changed several times over the last few years. Please remember that, some experts consider its definition different from the one given above.<\/p>\n
But, in general it is known that there can be widespread abnormalities in the body systems, which may affect different organs or organ systems and can result in failure of organs (Multiple organ dysfunction syndrome – MODS) and death. Severity of sepsis can range from septicemia, bacteremia, sepsis and septic shock to MODS and death.<\/p>\n
In fact, sepsis is the better word to be used to describe the conditions related to infection of blood and its complications, as it is better defined than the others (1,<\/strong> 2<\/strong>)<\/sup>.<\/p>\nPrevention, early diagnosis and treatment at the earliest possible occasion help to prevent the complications and problems that may arise due to sepsis.<\/p>\n
Commonly used terms<\/h2>\n
In relation to septicemia, it is very common for people to use the term with the organism that causes the condition, or with the location the infection is or maybe with the condition itself. Few examples can be seen below(1, 3, 4, 5, 6<\/strong>)<\/sup>.<\/p>\n\n- Gram negative septicemia –<\/strong> Bacteria are classified based on their staining properties. They are classified as gram negative and gram positive bacteria. When a septicemia is due to a gram negative organism, then it can be called as gram negative septicemia.<\/li>\n
- Gram positive septicemia –<\/strong> Gram positive organism causing septicemia.<\/li>\n
- Meningococcal septicemia –<\/strong> Meningococcus is a bacterium that can cause meningitis. It can cause septicemia.<\/li>\n
- Puerperal septicemia –<\/strong> Infection in blood during the period of child birth.<\/li>\n
- Neonatal septicemia –<\/strong> Septicemia in a neonate<\/li>\n
- Wound septicemia –<\/strong> Septicemia that originates from a wound infection.<\/li>\n
- MRSA septicemia –<\/strong> Methicillin resistant Staphylococcus aureus can cause septicemia.<\/li>\n<\/ul>\n
How do you get Sepsis? (Pathophysiology of sepsis)<\/h2>\n
When an infective organism enters the blood, our body recognizes it and tries to neutralize the infection. This is done by certain cells of our system (macrophages and neutrophils) by either phagocytosing (eating) them or neutralizing it by release of chemicals. This is usually limited to the site of infection. On occasions, the body reaction goes uncontrolled and spreads to different regions through blood circulation (1, 7<\/strong>)<\/sup>.<\/p>\nThe origin of the reaction can be an infective source (organism, toxins of organisms, enzymes of organisms etc) or a non-infective source. When a non-infective condition such as trauma, pancreatitis etc results in such a reaction, then it is called a Systemic Inflammatory response Syndrome (SIRS).<\/p>\n
The uncontrolled and unregulated immune response occurring thus is termed as sepsis. Though the exact mechanism that causes the immune response is not known, it is suggested that various factors could lead to the state. The bacterial toxins, bacterial cell wall components, excess inflammatory mediators, complement system activation and genetic predisposition are all suggested factors for the same.<\/p>\n
The immune response through various mechanisms, that are unclear till now, causes the cells of various organs to get damaged and die. When multiple cells start dying in various organs such as blood vessels, lungs, kidneys, liver etc, the organs themselves start to fail, resulting in hypotension (septic shock), multiple organ dysfunction syndrome- MODS, and finally death.<\/p>\n
![\"A](\"https:\/\/emedicalupdates.com\/wp-content\/uploads\/2018\/01\/A-picture-demonstrating-the-broad-pathophysiology-of-sepsis-image-photo.jpg\")
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Picture 1: A picture demonstrating the broad pathophysiology of sepsis.
\nImage Source: media.mercola.com<\/p>\n
Many a times, the question that is asked by common people is \u2018Is sepsis contagious\u2019? Sepsis as a condition is not contagious (1<\/strong>)<\/sup>. But, when sepsis is due to an organism such as bacteria, virus or fungus, the organism can spread from person to person and cause various infections (1<\/strong>)<\/sup>. For the said reason, it is very important to maintain sterile conditions while visiting a patient with sepsis (1<\/strong>)<\/sup>.<\/p>\nSepsis – Risk factors<\/h2>\n
Sepsis can occur in any individual. However, there are certain groups of individuals who are more prone to sepsis and its complications. The high risk groups to sepsis includes (1, 2, 8, 9<\/strong>)<\/sup><\/p>\n\n- Age:<\/strong> People who are at extremes of age are more prone to sepsis. Advanced age (more than 65yrs) or too young are included in this group.<\/li>\n
- Immunosuppression<\/strong>: Those who are under immunosuppressive medications (Anticancer medications, post organ transplant etc) or with immunosuppression due to disease condition (HIV infection) can be at higher risk to sepsis.<\/li>\n
- Increased risk to infections due to diabetes or cancer<\/li>\n
- Intensive care unit stay:<\/strong> Nosocomial infections are higher in intensive care and thus resulting in higher chances of sepsis.<\/li>\n
- Patients with severe wounds or burns.<\/li>\n
- Patients in whom spleen is removed. Spleen is an important organ in our body defense mechanism. Its removal can lead to frequent infections and sepsis.<\/li>\n
- Genetic predisposition to sepsis.<\/li>\n
- Patients with intravenous catheters, intra-urethral catheters and other invasive supportive devices.<\/li>\n<\/ul>\n
Signs and Symptoms of Sepsis<\/h2>\n
It is very critical to identify and initiate treatment for anyone suspected to have sepsis. The continuum of sepsis in its early phase can be represented by an infection or bacteremia. A \u2018Quick Sequential Organ Failure Assessment Score\u2019 (qSOFA score)<\/strong> helps in diagnosing early sepsis.<\/p>\nThis is easy and immediate to identify the condition, considering that only three factors need to be assessed. An altered mental status, respiratory rate equal to or more than 22 per minute and Systolic blood pressure equal to or less than 100mm of Hg. If any two of these are positive, the person is considered to be in early sepsis(1, 2, 8, 9<\/strong>)<\/sup>.<\/p>\n![\"Stages](\"https:\/\/emedicalupdates.com\/wp-content\/uploads\/2018\/01\/Stages-of-sepsis-image-photo-picture.jpg\")
<\/p>\n
Picture 2: Stages of sepsis
\nPhoto Source: i0.wp.com\/ionhealthcarepulse.com<\/p>\n
According to many experts sepsis can be divided into three stages. Many others do not consider this division.<\/p>\n
1. Early sepsis<\/h3>\n
as discussed above is diagnosed by qSOFA score.<\/p>\n
![\"\"](\"https:\/\/emedicalupdates.com\/wp-content\/uploads\/2018\/01\/ICD-10-code-for-sepsis-A41.9.jpg\")
<\/p>\n![\"Clinical](\"https:\/\/emedicalupdates.com\/wp-content\/uploads\/2018\/01\/Clinical-features-of-sepsis-image-picture-photo.jpg\")
<\/p>\n![\"Treatment](\"https:\/\/emedicalupdates.com\/wp-content\/uploads\/2018\/01\/Treatment-general-outline-in-a-case-of-sepsis-image-photo-picture.jpg\")
<\/p>\n