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Blood Poisoning

(Sepsis; Septicemia)

Definition

Blood poisoning is an illness due to an infection or its toxin spreading through the bloodstream. The presence of bacteria in the blood is called bacteremia.
Short bursts of low levels of bacteria in the blood usually do not cause problems. However, if bacteria levels do not decrease sepsis may occur. This is a serious condition which can lead to death.

Causes

Sepsis occurs when large numbers of infectious agents exist in the blood. Infections with fungi and parasites may lead to sepsis as well. The initial infection often comes from:
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Bacteria can also enter the bloodstream directly from an outside source. A dirty needle used by an IV drug user can cause this type of infection. In some cases, the source of the infection is unknown.
Small amounts of bacteria enter into the blood with dental work or when brushing your teeth. Your body's immune system should fight off these bacteria.

Risk Factors

Factors that increase your chance of getting sepsis include:
  • Recent illness or hospital care
  • Frail health due to increased age
  • Poorly working immune system due to:
    • Cancer or chemotherapy to treat cancer
    • Diabetes
    • AIDS or another immunosuppressive condition, such as an autoimmune disease or an immune deficiency
    • Immunosuppressive medications needed after a transplant
  • Medical treatment with an invasive device
  • IV drug abuse

Symptoms

The first symptoms depend on the site of the infection.
As the condition progresses to sepsis, symptoms include:
  • Fever and chills
  • Low temperature
  • Paleness of skin color
  • Listlessness
  • Changes in mental status
  • Rapid breathing
  • Increased heart rate
  • Decreased urine
  • Low blood pressure
  • Shock
  • Problems with bleeding or clotting

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. If sepsis is suspected, the doctor will try to find the source of the infection.
Tests include:
  • Several blood cultures to confirm the diagnosis of sepsis
  • Urine and other blood tests to check for signs of infection
  • Cultures of urine, sputum, stool, and other secretions to check for bacteria or other infectious agents
  • X-rays—a test that uses radiation to take a picture of structures inside the body
  • CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the body
  • Other specialized tests depending on the source of the infection

Treatment

This condition will need to be treated aggressively. Treatment is aimed at the cause of the initial infection.
Early treatment improves the chance of survival. Life-saving steps may be needed to assist breathing and heart function. Patients usually need to be observed in an intensive care unit.

Medication

IV antibiotics will be used to fight the initial infection and to clear it from your blood. You will be given oral antibiotics when you leave the hospital.

Surgery

Surgery is sometimes needed to remove or drain the initial infection.

Supportive Care

You will likely receive other medications, IV fluids, and oxygen. If your blood pressure remains too low, you may need vasopressors—medicines to help maintain your normal blood pressure. Blood transfusions and a respirator (to help you breathe) may be necessary in some cases.
Further treatment depends on how your body is responding. For example, you may need kidney dialysis if kidney failure occurs.

Prevention

It is not always possible to prevent blood poisoning. Avoiding IV drug abuse decreases your chance of sepsis. Healthcare professionals must also take steps to stop the spread of these infections. Getting prompt medical care for infections can reduce your risk of sepsis.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

Society of Critical Care Medicine http://www.sccm.org

CANADIAN RESOURCES

Communicable Disease Control Unit (Manitoba Health, Public Health Branch) http://www.gov.mb.ca

Health Canada http://www.hc-sc.gc.ca

References

Bone RC. Pulmonary & Critical Care Medicine. 1998 ed. St. Louis, MO:Mosby-Year Book, Inc.;1998.

Cecil RL, Goldman L, et al. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA:WB Saunders Company;2000.

Conn HF, Rakel R. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA:WB Saunders Company;2001.

Kasper DL, Harrison TR. Harrison’s Principles of Internal Medicine. 17th ed. New York, NY:McGraw Hill;2008.

Mandell GL, Douglas RG, et al. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA:Churchill Livingstone, Inc.;2000.

Neonatal sepsis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated September 7, 2012. Accessed October 12, 2012.

Sepsis in adults. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated October 8, 2012. Accessed October 12, 2012.

Sepsis in children. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated February 9, 2012. Accessed October 12, 2012.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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