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Sepsis, a deadly condition that must be treated fast

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C. A. V. Nogueira, M.D. | Saturday February 2, 2019 7:01AM ET
Sepsis
Infection   Our immune system is a fantastic thing. When it works

Sepsis, septicaemia or blood poisoning as it is known, is a serious complication of an infection that can't wait: without fast help it can lead to multiple organ failure and death.


Our immune system is a fantastic thing: it fights bacteria, viruses and any other foreign body that attacks our body and its main purpose is to prevent an infection.

If an infection occurs, our immune system will fight it with or without some additional help in form of drugs we may be taking.

But, a bad thing happen when the patient' immune system, for some known or unknown reason, turns away from foreign attackers and starts to attack the body it was suppose to defend. It is obvious that this is a bad thing: this is an attack from the inside and the patient doesn't have a natural defense anymore. And this is the start of sepsis.

So, let's take a look at the symptoms first because TIME is of utmost importance. And TIME is Temperature, Infection, Mental decline, Extremely ill.

Temperature is going up and down but in usual circumstance and with usual activities, in a healthy body it stays somewhere around 37C. When an infection occurs, the patient's body shifts the temperature up and the goal is to fight off the attacker.

We all know that the higher temperature is a sign something is going on, and doctors know that usually there is no reason for panic if it is under 37C.

But, in some people their body temperature may go down in a case of an illness, so every fluctuation in temperature can be a sign of sepsis.

Infection: If the patient has symptoms of an infection, from some serious illness such as pneumonia all the way to almost invisible cut, they are located around the area being hit.

However, if symptoms start to spread, for example if you see red lines starting to go from the finger you cut in the kitchen toward your elbow, this is a sign that your next stop is ER as soon as possible.

This is all fine and well if the patient knows that there is an infection. But all people that undergo a surgery recently, or been in a contact with a sick person, or have a skin cut, should be very careful too because every infection can potentially turn to sepsis.

Mental decline: Sepsis can affect patient's mental state and in some patient they will show before usual signs of infection. As a rule of thumb, any sudden change in mental status, especially in old patients is a sign that something is very wrong.

Symptoms as sudden dementia, confusion, or severe sleepiness are signs that will raise the alarm in the doctor's head.

Extremely ill: Every person has it's own definition of pain and "I feel bad," but if there is a severe pain and if the person says "This is worst I ever felt" this is a reason to suspect that sepsis may be in the game.

Along with all those symptoms, blood test will be used to get the doctor to the right diagnosis. There is not a unique sepsis blood test, but when the doctor take all them into account, and mix that with the symptoms, the picture may be clear.

There are following confirmatory tests that give the doctor more information. And, the doctor may decide to perform additional tests just to be sure.

The point is, all that should be done fast and if there is a reason to believe that sepsis is present, the treatment must be started before all test results come back.

Now, who is in danger? Usual suspect, we would say: very young people, very old people, patients with a chronic disease, patients with a weak immune system, and patient that recently underwent a medical procedure.

What happens in a case of sepsis? Along with visible symptoms, the patient may have breathing problem, kidney problem that lead to no urine, changes in the brain, liver problems... And that comes the septic shock which is one step away from being dead.

We see that sepsis leads to multiple organ failure and it is obvious that in that cases patients must be treated in an intensive care unit because the death is the outcome if left untreated.

What's the prognosis?

Unfortunately, the numbers are not good. Some 30% of patients with severe sepsis die. Some 50% of those who survive suffer from some form of post-sepsis syndrome. They go from post-traumatic stress disorder (PTSD) to organs that don’t work properly to chronic pain or fatigue and amputations.

So, what can we do to minimize the risk?

First, be vaccinated. There is no reason to catch a well-know disease that can be prevented by simple vaccination. Then, if you have an infection, no matter how small it may look, seek doctor's help.

Remember what they thought you when you were young: wash your hands before you grab your food or do anything on your body with them.

And maybe one of the most important advice: Don't think anybody in ER will call you coward or "little baby" if you come in with a problem that turns to be nothing serious. They won't. And that's better than to be a hero and try to heal an infection by yourself. Because the time may come when you won't have time to get to ER.

 

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