Septicemia

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Overview

Despite progress in antimicrobial therapy, septicemia remains a major problem of modern medicine. The clinical features and outcome may vary in different clinical settings and in a single setting during the years. As an example, gram-negative bacilli have been the prevalent cause of fulminant septicemia in granulocytopenic patients during the seventies. Nowdays, the use of indwelling central venous catheters and/or quinolone prophylaxis have favored the emergence of coagulase-negative staphylococci as a major cause of septicemia in these patients. As a consequence, the optimal management of febrile episodes in granulocytopenic patients should include not only a combination of a broad spectrum betalactam plus an aminoglycoside to prevent early death from gram-negative septicemia, but also antistaphylococcal antibiotics in cases not improving after 72 hours. The clinical spectrum of infective endocarditis continues to evolve. Infection of the right heart valves that was rare until a few decades ago, is now a frequent cause of staphylococcal septicemia in intravenous drug addicts. Along with prosthetic valve infection, new clinical syndromes of nosocomial endocarditis are emerging. Infections of permanent central venous catheters, ventriculoatrial shunts or pace-maker leads may in fact cause right-sided infective endocarditis. Septicemia will continue to challenge physicians in the future.

Symptoms

The symptoms of septicemia usually start quickly. Even in the first stages, a person can look very sick.

Symptoms may follow an injury, surgery, or another localized infection, such as pneumonia. The most common initial symptoms are:

chills

fever

breathing very fast

rapid heart rate

More severe symptoms will begin to emerge as septicemia progresses without proper treatment. These include the following:

confusion or the inability to think clearly

nausea and vomiting

red dots that appear on the skin

reduced urine volume

inadequate blood flow

shock

Causes

Bacteria, viruses and fungi can enter the bloodstream in many ways, for example:

Abscessed tooth.

Germs on medical equipment (such as surgical tools and needles).

Kidney infection.

Pneumonia.

Skin ulcers or other wounds.

Urinary tract infection.

The body usually can remove a small number of germs naturally. But if germs continue to grow and spread, that can lead to septicemia.

Risk factors

People who are already in the hospital for something else, such as a surgery, are at a higher risk of developing septicemia. Secondary infections can occur while in the hospital. These infections are often more dangerous because the bacteria may already be resistant to antibiotics.

Others at a higher risk of developing septicemia include:

people who have severe wounds or burns

babies

older adults

people with a compromised immune system, which can occur from conditions (such as HIV or leukemia) or medical treatments (such as chemotherapy or steroid injections)

people with diabetes

people who have a urinary or intravenous catheter

people who are on mechanical ventilation

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Complications

Septicemia has a number of serious complications. These complications may be fatal if left untreated or if treatment is delayed for too long.

Sepsis

Sepsis occurs when your body has a strong immune response to the infection. This leads to widespread inflammation throughout the body. It’s called severe sepsis if it leads to organ failure, such as kidney or heart failure.

People with chronic conditions are at a higher risk of sepsis. That’s because they have a weakened immune system and can’t fight off the infection on their own.

Septic shock

One complication of septicemia is a serious drop in blood pressure, which is called septic shock. Toxins released by the bacteria in the bloodstream can cause extremely low blood flow, which may result in organ or tissue damage.

Septic shock is a medical emergency. People with septic shock are usually cared for in a hospital’s intensive care unit (ICU). You’ll need medications to increase your blood pressure. You may also need to be put on a ventilator.

Acute respiratory distress syndrome (ARDS)

A third complication of septicemia is acute respiratory distress syndrome (ARDS). This is a life threatening condition that prevents oxygen in your lungs from reaching your blood.

It often results in some level of permanent lung damage. It can also damage your brain, leading to memory problems.

Prevention

Preventing infection is the best way to prevent sepsis. Take these steps:

Wash your hands often with soap and water for at least 20 seconds each time.

Keep up with recommended vaccines for things like flu and chickenpox.

Keep control of any chronic health conditions.

If you have an injury that’s broken your skin, clean it as soon as possible. Keep it clean and covered as it heals, and watch for signs of infection.

Treat any infections. Get medical care right away if they don’t get better or if they seem like they’re getting worse.