Afternoon D & C Dedicated To Mumbai


Wednesday, November 15, 2017

Fever and the flu may be going around, but here’s something more serious. Sepsis is an infection that mimics signs of fever and general illness, and Sunny Rodricks tells you why you need to read more carefully into the signs

A potentially life-threatening infection, sepsis can cause a cascade of changes that can damage multiple organ systems. “Sepsis is a condition that arises when the body’s response to infection causes injury to its own tissues and organs. Most commonly, the infection is bacterial, but it may also be from fungi, viruses or parasites. Common locations for the primary infection include the lungs, brain, urinary tract, skin and abdominal organs,” says Dr. Vikrant Shah, internal medicine expert, Zen Multi Specialty Hospital, Chembur. In its severe form, blood pressure levels may become dangerously low. India itself witnesses more than 1 million cases per year of sepsis alone, so it is more common than you might think.

The early symptoms of sepsis include a fever and feeling unwell, faint or weak. You may notice that your heart rate and breathing become faster than usual. If left untreated, sepsis can lead to diarrhoea and nausea. Other symptoms include:

  • Disorientation or confusion
  • Bluish or purple hands or feet, caused by reduced circulation
  • Death of bone tissue due to a lack of blood supply
  • Nausea, vomiting or diarrhoea
  • Fever, weakness or confusion
  • A cough with pneumonia or painful urination with a kidney infection

Sepsis is most commonly seen in elderly people, people who have diabetes or cancer, and in children less than three-months-old. However, anyone can be at the risk of developing sepsis, even from minor infections. People who are in hospital for other serious illnesses are also at risk of developing sepsis. The following are the risk factors for sepsis:

  • A medical condition that weakens the immune system, such as HIV or leukemia
  • A compromised immune system
  • Being very young or very old
  • A long-term health condition such as diabetes or cancer
  • Wounds or injuries such as burns
  • Recent surgery, wounds or injuries
  • Being on ventilation support (a machine is used to help you breathe)
  • If drips or catheters are attached to your skin

Your doctor is in the best position to diagnose sepsis, based on your history and current condition. Doctors may ask for blood, urine and other tests to confirm sepsis, and X-ray scans, CT scans and even MRI scans to pinpoint the source.

Sepsis is not something to take lightly, and it can quickly progress to septic shock. Dr. Chandrashekhar Tulasigeri, consultant, Critical Care Medicine and HOD of Intensive Care Medicine at Hiranandani Hospital, Vashi, says, “Sepsis treatment should be administered as soon as it is diagnosed. Patients with sepsis who show no sign of organ failure have a survival rate of 75-85%, whereas those who have developed septic shock or severe sepsis have a survival rate of less than 40%.”

“Sepsis is usually treated with intravenous fluids and antibiotics. Generally, antibiotics are given as soon as possible. If fluid replacement is not enough to maintain blood pressure, medications that raise blood pressure may be used. These are called ion tropic supports. Mechanical ventilation and dialysis may be needed to support the functioning of the lungs and kidneys, respectively,” says Dr. Vikrant.

Although people who develop sepsis can recover fully, the chances of relapse are high. The length of time for recovery from sepsis depends upon the severity of the condition, an individual’s overall health, the amount of time spent under the doctor’s guidance and whether intensive care treatment was needed.

Doctors across the world view sepsis as a three-stage syndrome. Their goal is to treat sepsis during its early stage, before it becomes dangerous and potentially life-threatening. Once it progresses to advanced stages, organ failure can result, which may be irreversible. Dr. Chandrashekhar tells us, “The systemic response to any class of microorganism can be harmful. Microbial invasion of the bloodstream is not essential because local inflammation can also provoke distant organ dysfunction and hypotension.”

  • Sepsis: This is caused by a heightened immune response triggered by an infection.
  • Severe sepsis: This is the second stage and characterised by decreased organ function or organ failure.
  • Septic shock: This is when severe sepsis is combined with a drastic drop in blood pressure.
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