Septicemia

Also known as: Blood poisoning and Bacteremia with sepsis

Definition

Septicemia is the presence of bacteria in the blood (bacteremia) and is often associated with severe infections.

Causes, incidence, and risk factors

Septicemia is a serious, life-threatening infection that gets worse very quickly. It can arise from infections throughout the body, including infections in the lungs, abdomen, and urinary tract. It may come before or at the same time as infections of the bone (osteomyelitis), central nervous system (meningitis), heart (endocarditis), or other tissues.

Symptoms

Septicemia can begin with spiking fevers, chills, rapid breathing, and rapid heart rate. The person looks very ill.

The symptoms rapidly progress to shock with fever or decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood clotting problems that lead to a specific type of red spots on the skin (petechiae and ecchymosis).

There may be decreased or no urine output.

Signs and tests

A physical examination may show:

• Low blood pressure
• Low body temperature or fever
• Signs of associated disease (such as meningitis, epiglottitis, pneumonia, or cellulitis)

Tests that can confirm infection include:

• Blood culture
• Blood gases
• CBC
• Clotting studies
  • PT
  • PTT
  • Fibrinogen levels
• CSF culture
• Culture of any suspect skin lesion
• Platelet count
• Urine culture

Treatment

Septicemia is a serious condition that requires a hospital stay. You may be admitted to an intensive care unit (ICU).

Fluids and medicines are given by an IV to maintain the blood pressure.

Oxygen will be given. Antibiotics are used to treat the infection.

Plasma or other blood products may be given to correct any clotting abnormalities.

Expectations (prognosis)

What to expect depends on the organism involved and how quickly the patient is hospitalized and treatment begins. The death rate is high -- more than 50% for some organisms.

Complications

Septicemia can rapidly lead to adult respiratory distress syndrome (ARDS), septic shock, and death.

Septicemia associated with meningococci can lead to shock or adrenal collapse ( Waterhouse-Friderichsen syndrome).

Calling your health care provider

Septicemia is not common but is devastating. Early recognition may prevent progression to shock.

Seek immediate care if:

• A person has a fever, shaking chills, and looks very ill
• Any person who has been ill has changes in mental status
• There are signs of bleeding into the skin

Call your health care provider if your child's vaccinations are not up-to-date.

Prevention

Appropriate treatment of localized infections can prevent septicemia. The Haemophilus influenza B (HIB) vaccine and S. pneumoniae vaccine have already reduced the number of cases of septicemia in children. Both are recommended childhood immunizations.

In certain cases, people who are in close contact with someone with septicemia may be prescribed preventative antibiotics.

References

Enrione MA, Powell KR. Sepsis, septic shock, and systemic inflammatory response syndrome. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 176.

Munford RS. Sepsis, severe sepsis, and septic shock. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2005: chap 67.

Shapiro NI, Zimmer GD, Barkin AZ. Sepsis syndromes. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 136.

See also:

• Disease

  Sepsis

  

  Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria.

• Disease

  Waterhouse-Friderichsen syndrome

  

  Waterhouse-Friderichsen syndrome is adrenal gland failure due to bleeding into the adrenal gland. It is caused by severe meningococcal infection or other severe, bacterial infection. Symptoms include acute adrenal gland insufficiency and profound . It is deadly if not treated immediately.

• Disease

  Septic shock

  Septic shock is a serious condition that occurs when an overwhelming infection leads to life-threatening low blood pressure. See also:

• Injury

  Shock

  

  Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. This can damage multiple organs. Shock requires immediate medical treatment and can get worse very rapidly.

• Disease

  Meningitis

  

  Meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges). See also:

• Disease

  Bleeding disorders

  Bleeding disorders are a group of conditions in which there is a problem with the body’s blood clotting process. These disorders can lead to heavy and prolonged bleeding after an injury. Bleeding can also begin on its own. See also: Drug-induced immune thrombocytopenia deficiency (type I and ...

• Special Topic

  Central nervous system

  

  The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main “processing center” for the entire nervous system, and control all the workings of your body.

• Disease

  Osteomyelitis

  

  Osteomyelitis is an or bone infection.

• Disease

  Acute respiratory distress syndrome

  

  Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition that prevents enough oxygen from getting into the blood. See also:

Review date:

August 28, 2009

Reviewed by:

Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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