Sepsis is a systemic inflammatory response to a severe infection. The inflammatory response triggers a rapid series of events, such as leaking blood vessels and impaired blood flow.
Severe sepsis is associated with a drop in blood pressure. Low blood pressure reduces the amount of oxygen and nutrients going to the body's organs. This drop causes damage to the body's major organs.
Septic shock occurs when adequate blood pressure cannot be restored despite treatment with IV fluids. Septic shock may lead to multiple organ failure and death.
Septic shock is caused by an infection that overwhelms the body. Sepsis can be triggered by many different kinds of infections including:
- Bacterial—most common
- Fungal infections
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Septic shock is more common in infants and in people over 50 years old. Other factors that may increase your chances of septic shock include:
- Weakened immune system
- Absence of your spleen
- Low white blood cell counts
- Chronic diseases
- Previous surgery
Septic shock may cause:
- Fever, which may be followed by a drop in body temperature to below normal
- Warm, flushed skin
- Rapid, pounding heartbeat
- Rapid breathing or trouble breathing
- Reduced alertness
- Irregular blood pressure
- Reduced urination
- Severe bleeding— disseminated intravascular coagulation
Complications from septic shock may cause symptoms of:
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- Blood tests to assess white blood cell counts and inflammatory markers that might indicate how serious the infection is, as well as oxygen levels and kidney function to assess damage to specific organs.
- Cultures to check for infectious organisms
- ECG to check for heart rhythm irregularities
- Imaging tests may be used to look for specific sources of infection, such as pneumonia
Sepsis and septic shock require immediate care. Treatment includes the following:
Supportive Measures for Shock
If you have septic shock, you will be admitted to the intensive care unit. There you will be given:
- IV fluids
- Medications to increase blood pressure and blood flow to your organs
- Extra oxygen
- Corticosteroids may be needed to reduce the inflammatory response, especially if fluids aren't working
If your lungs fail, you may be put on a mechanical ventilator to help you breathe. Other therapies or supportive measures may be used.
You will be given high doses of one or more antibiotics or antifungal medications. The medications may be changed once the specific cause of the infection is identified.
Surgery may be performed to remove any dead tissue or drain infections.
Most cases of septic shock cannot be prevented. Promptly treating bacterial and other infections may help.
Centers for Disease Control and Prevention https://www.cdc.gov
Society of Critical Care Medicine http://www.sccm.org
CAEP—Canadian Association of Emergency Physicians http://www.caep.ca
Health Canada https://www.canada.ca
Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304-377.
Sepsis and septic shock. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/critical-care-medicine/sepsis-and-septic-shock/sepsis-and-septic-shock. Updated April 2016. Accessed December 15, 2017.
Sepsis. National Institute of General Medical Sciences website. Available at: https://www.nigms.nih.gov/Education/Pages/factsheet%5Fsepsis.aspx. Updated December 11, 2017. Accessed December 15, 2017.
Sepsis in adults. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T115805/Sepsis-in-adults . Updated July 28, 2017. Accessed December 15, 2017.
Sepsis treatment in adults. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T316889/Sepsis-treatment-in-adults . Updated November 17, 2017. Accessed December 15, 2017.
- Reviewer: EBSCO Medical Review Board Marcie L. Sidman, MD
- Review Date: 11/2018
- Update Date: 01/09/2017