Many doctors view sepsis as a three-stage syndrome, starting with sepsis and progressing through severe sepsis to septic shock. The goal is to treat sepsis during its mild stage, before it becomes more dangerous.
To be diagnosed with sepsis, you must exhibit at least two of the following symptoms:
- Fever above 101.3 F (38.5 C) or below 95 F (35 C)
- Heart rate higher than 90 beats a minute
- Respiratory rate higher than 20 breaths a minute
- Probable or confirmed infection
Your diagnosis will be upgraded to severe sepsis if you also exhibit at least one of the following signs and symptoms, which indicate an organ may be failing:
- Significantly decreased urine output
- Abrupt change in mental status
- Decrease in platelet count
- Difficulty breathing
- Abnormal heart pumping function
- Abdominal pain
To be diagnosed with septic shock, you must have the signs and symptoms of severe sepsis — plus extremely low blood pressure that doesn't adequately respond to simple fluid replacement.
When to see a doctor
Most often sepsis occurs in people who are hospitalized. People in the intensive care unit are especially vulnerable to developing infections, which can then lead to sepsis. If you get an infection, or if you develop signs and symptoms of sepsis after surgery, hospitalization or an infection, seek medical care immediately.
Diagnosing sepsis can be difficult because its signs and symptoms can be caused by other disorders. Doctors often order a battery of tests to try to pinpoint the underlying infection.
A sample of your blood can be tested for:
- Evidence of infection
- Clotting problems
- Abnormal liver or kidney function
- Impaired oxygen availability
- Electrolyte imbalances
Other laboratory tests
Depending on your symptoms, your doctor may also want to run tests on one or more of the following bodily fluids:
- Urine. If your doctor suspects that you have a urinary tract infection, he or she may want your urine checked for signs of bacteria.
- Wound secretions. If you have a wound that appears infected, testing a sample of the wound's secretions can help show what type of antibiotic might work best.
- Respiratory secretions. If you are coughing up mucus (sputum), it may be tested to determine what type of germ is causing the infection.
If the site of infection is not obvious, your doctor may order one or more of the following imaging tests:
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- X-ray. Using low levels of radiation, X-rays are good for visualizing problems in the lungs. X-rays are painless and take only a few minutes to complete.
- Computerized tomography (CT). Infections in the appendix, pancreas or bowels are easier to see on CT scans. This technology takes X-rays from a variety of angles and combines them to depict cross-sectional slices of your body's internal structures. The test is painless and usually takes less than 20 minutes.
- Ultrasound. This technology uses sound waves to produce real-time images on a video monitor. Ultrasound may be particularly useful to check for infections in your gallbladder or ovaries.
- Magnetic resonance imaging (MRI). MRIs may be helpful in identifying soft tissue infections, such as abscesses within the spine. This technology uses radio waves and a strong magnet to produce cross-sectional images of your internal structures.
- Sepsis fact sheet. National Institute of General Medical Sciences. http://www.nigms.nih.gov/Publications/factsheet_sepsis.htm. Accessed Oct. 24, 2012.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Oct. 25, 2012.
- .Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Oct. 25, 2012.
- Chang HJ, et al. Patient page: Sepsis. Journal of the American Medical Association. 2010;304:1856.
- About sepsis. Society of Critical Care Medicine. http://www.survivingsepsis.org/Introduction/Pages/default.aspx. Accessed Oct. 25, 2012.
- Antonelli M, et al. Year in review in Intensive Care Medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation. Intensive Care Medicine. 2012;38:345.
- Skrupky LP, et al. Advances in the management of sepsis and the understanding of key immunological defects. Anesthesiology. 2011;115:1349.
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