Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Sepsis (blood poisoning) facts
- What is blood poisoning?
- What is sepsis?
- Why are there so many diseases with "sepsis," "septic," "septicemia," or "blood poisoning" in their name?
- What causes sepsis?
- What are the risk factors for sepsis?
- What are sepsis (blood poisoning) symptoms and signs?
- How do health-care professionals diagnose sepsis?
- What is the treatment for sepsis?
- What types of specialists treat sepsis?
- What is the prognosis with sepsis?
- What are the complications of sepsis?
- Is it possible to prevent sepsis (blood poisoning)?
- What are some additional sources for information on sepsis (blood poisoning)?
How do health-care professionals diagnose sepsis?
Clinically, the patient needs to fit at least two of the diagnostic criteria listed above and have a suspected or proven infection. This is a screening tool to help physicians presumptively diagnose sepsis early in the disease process. Definitive diagnosis depends on a positive blood culture for an infectious agent and at least two of the criteria. However, other helpful tests depend on lab analysis such as white blood cell examinations, procalcitonin levels, and PaCO2. These tests, like blood cultures, are measured in clinical laboratories. Researchers are currently investigating other blood tests to diagnose early sepsis. In addition, other underlying causes for sepsis are often established by using CT imaging studies, MRI, ultrasound, and chest X-rays. Sometimes it's difficult to differentiate between underlying causes of sepsis and other emergency medical problems. Consequently, it is not unusual to run cardiac studies to rule out heart disease on patients that may also have sepsis since some of the symptoms are similar.
There are other diagnostic findings that indicate the severity of the patient's sepsis. Severe sepsis is diagnosed when the septic patient has organ dysfunction (for example, low or no urine flow, altered mental status). Severe sepsis can also include sepsis-induced hypotension (also termed septic shock) when the patient's blood pressure falls.
What is the treatment for sepsis?
In almost every case of sepsis, patients need to be hospitalized, treated with appropriate intravenous antibiotics, and given therapy to support any organ dysfunction. Sepsis can quickly cause organ damage and death; therapy should not be delayed as statistics suggest as high as a 7% mortality increase per hour if antibiotics are delayed in severe sepsis. Most cases of sepsis are treated in an intensive-care unit (ICU) of the hospital.
Appropriate antibiotics to treat sepsis are combinations of two or three antibiotics given at the same time; most combinations usually include vancomycin to treat many MRSA infections. Some of the commonly used antibiotics used are
- ceftriaxone (Rocephin),
- meropenem (Merrem),
- ceftazidime (Fortaz),
- cefotaxime (Claforan),
- cefepime (Maxipime),
- piperacillin and tazobactam (Zosyn),
- ampicillin and sulbactam (Unasyn),
- imipenem/cilastatin (Primaxin),
- levofloxacin (Levaquin),
- clindamycin (Cleocin).
However, once the infecting organism is isolated, labs can determine which antibiotics are most effective against the organisms, and those antibiotics should be used to treat the patient. In addition to antibiotics, two other major therapeutic interventions, organ-system support and surgery, may be needed. First, if an organ system needs support, the intensive-care unit can often provide it (for example, intubation [mechanical ventilation] to support lung function or dialysis to support kidney function) or a central venous catheter and fluid replacement with intravenous fluids and/or antihypotensive medication to raise blood pressure (norepinephrine [Levophed] or phenylephrine [Neo-Synephrine] administered by IV). Secondly, surgery may be needed to drain or remove the source of infection. Amputation of extremities has been done to save some patients' lives.
Find out what women really need.