Overview

Sepsis is a potentially life-threatening condition that occurs when the body's response to an infection damages its own tissues. When the infection-fighting processes turn on the body, they cause organs to function poorly and abnormally.

Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can lead to severe organ problems and death.

Early treatment with antibiotics and intravenous fluids improves chances for survival.

Symptoms

Signs and symptoms of sepsis

To be diagnosed with sepsis, you must have a probable or confirmed infection and all of the following signs:

  • Change in mental status
  • Systolic blood pressure — the first number in a blood pressure reading — less than or equal to 100 millimeters of mercury (mm Hg)
  • Respiratory rate higher than or equal to 22 breaths a minute

Signs and symptoms of septic shock

Septic shock is a severe drop in blood pressure that results in highly abnormal problems with how cells work and produce energy. Progression to septic shock increases the risk of death. Signs of progression to septic shock include:

  • The need for medication to maintain systolic blood pressure greater than or equal to 65 mm Hg.
  • High levels of lactic acid in your blood (serum lactate). Having too much lactic acid in your blood means that your cells aren't using oxygen properly.

When to see a doctor

Most often, sepsis occurs in people who are hospitalized or who have recently been hospitalized. People in an intensive care unit are more likely to develop infections that can then lead to sepsis.

Any infection, however, could lead to sepsis. See your doctor about an infection or wound that hasn't responded to treatment. Signs or symptoms, such as confusion or rapid breathing, require emergency care.

Causes

While any type of infection — bacterial, viral or fungal — can lead to sepsis, infections that more commonly result in sepsis include infections of:

  • Lungs, such as pneumonia
  • Kidney, bladder and other parts of the urinary system
  • Digestive system
  • Bloodstream (bacteremia)
  • Catheter sites
  • Wounds or burns

Risk factors

Several factors increase the risk of sepsis, including:

  • Older age
  • Infancy
  • Compromised immune system
  • Diabetes
  • Chronic kidney or liver disease
  • Admission to intensive care unit or longer hospital stays
  • Invasive devices, such as intravenous catheters or breathing tubes
  • Previous use of antibiotics or corticosteroids

Complications

As sepsis worsens, blood flow to vital organs, such as your brain, heart and kidneys, becomes impaired. Sepsis may cause abnormal blood clotting that results in small clots or burst blood vessels that damage or destroy tissues.

Most people recover from mild sepsis, but the mortality rate for septic shock is about 40%. Also, an episode of severe sepsis places you at higher risk of future infections.

Jan. 19, 2021
  1. AskMayoExpert. Sepsis and septic shock. Mayo Clinic; 2019.
  2. Pomerantz WJ. Systemic inflammatory response syndrome (SIRS) and sepsis in children: Definitions, epidemiology, clinical manifestations, and diagnosis. https://www.uptodate.com. Accessed Dec. 18, 2020.
  3. Singer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016; doi:10.1001/jama.2016.0287.
  4. Bennett JE, et al. Sepsis and septic shock. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 18, 2020.
  5. Neviere R. Sepsis syndromes in adults: Epidemiology, definitions, clinical presentation, diagnosis, and prognosis. https://www.uptodate.com/contents/search. Accessed Dec. 17, 2020.
  6. Rhodes A, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Intensive Care Medicine. 2017; doi:10.1007/s00134-017-4683-6.
  7. Schmidt GA, et al. Evaluation and management of suspected sepsis and septic shock in adults. https://www.uptodate.com/contents/search. Accessed Dec. 15, 2020.
  8. Sepsis and septic shock. Merck Manual Professional Version. https://www.merckmanuals.com/professional/critical-care-medicine/sepsis-and-septic-shock/sepsis-and-septic-shock. Accessed Dec. 15, 2020.