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When the human body is invaded by an infectious organism (such as a bacterium, fungus, or virus), it fights back with a number of defense systems, including activation of numerous immune cells and molecules that help trap and kill the organism. The battle between the infection and the body's defenses can escalate, and the defenses themselves can unfortunately damage or impair vital organ function. Sepsis is a broad term that describes the syndrome of the body trying to fight a potentially serious infection. Sepsis is termed severe sepsis when this battle leads to acute vital organ damage. For example, a patient trying to fight pneumonia develops severe sepsis if the pneumonia is complicated by damage to the brain, heart, liver, lungs, or kidneys. Ultimately, death occurs in 20% to 50% of those who have severe sepsis. The most profound form of severe sepsis is septic shock (sepsis associated with hypotension [low blood pressure] despite replacement of intravenous fluids). The June 17, 2009, issue of JAMA includes an article about septic shock.
Signs and symptoms
Temperature above 38°C (101°F) or below 36°C (96°F)
Heart rate above 90 beats per minute
Breathing more than 20 breaths per minute
Low blood pressure
Decreased urine output
Change in mental status with confusion or delirium
Extreme alterations in white blood cell and platelet (blood cells that assist in clotting) counts
Sepsis can be the result of infection that spreads from certain areas of the body. Some of the most common sites are
Lung due to pneumonia
Skin, including cellulitis (infection of the skin), surgical wounds, pressure ulcers (bed sores), or infections around intravenous lines
Intestines if perforation (a hole causing leakage of contents) into the abdominal cavity occurs
Kidneys due to urinary tract infections
Brain if meningitis (infection of the lining of the brain) occurs
Bone if osteomyelitis (infection of the bone) occurs
Sepsis is a medical emergency and is usually treated in an intensive care unit (ICU). Other aspects of treatment may include
Intravenous fluids and medications to maintain a normal blood pressure
Medications to treat the infection
Mechanical ventilation if necessary to assist with breathing
Corticosteroid therapy to treat the inflammatory process
For more information
The International Sepsis Forumhttp://www.sepsisforum.org
The Surviving Sepsis Campaignhttp://www.survivingsepsis.org/sepsis/what_you_should_know
To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on ICUs was published in the March 25, 2009, issue; one on wound infections in the October 26, 2005, issue; and one on ventilator-associated pneumonia in the August 20, 2008, issue.
Source: National Institutes of Health
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: CRITICAL ILLNESS
Hildreth CJ, Lynm C, Glass RM. Sepsis. JAMA. 2009;301(23):2516. doi:10.1001/jama.301.23.2516
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