Sepsis - Symptoms

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What are the signs or symptoms of sepsis (blood poisoning)?

The adult patient should have a proven or suspected source of an infection (usually bacterial) and have at least two of the following problems: an elevated heart rate (tachycardia), either a high (fever) or low temperature (hypothermia), rapid breathing (>20 breaths per minute or a reduced PaCO2 level), or a white blood cell count that is either high, low, or composed of >10% band cells. In most cases, it is fairly easy to ascertain heart rate (count pulse per minute), fever or hypothermia with a thermometer, and to count breaths per minute even at home. It may be more difficult to prove a source of infection, but if the person has symptoms of infection such as productive cough, or dysuria, or fevers, or a wound with pus, it is fairly easy to suspect that a person with an infection may have sepsis. However, determination of the white blood cell count and PaCO2 is usually done by a lab. In most cases, the definitive diagnosis of sepsis is made by a physician in conjunction with laboratory tests.

Elderly patients have similar symptoms to those stated for adults, but the first apparent symptoms are often confusion along with chills, weakness, possibly faster breathing, and a dusky skin appearance. Pediatric patients (infants, toddlers, and children) also may develop similar symptoms to those in adults, but the most common symptoms are fever and reduced urine output. Children may show signs of lethargy and decreased age-appropriate mental status. Neonatal sepsis (sepsis neonatorum) is suspected in neonates up to 28 days old if the rectal temperature is 100.4F or higher. Other signs and symptoms for neonatal sepsis include fever in the mother at time of delivery, cloudy or smelly amniotic fluid, abnormal vital signs, seizures, and projectile vomiting.

Some authors consider red lines or red streaks on the skin to be signs of sepsis. However, these streaks are due to local inflammatory changes in either local blood vessels or lymphatic vessels (lymphangitis). The red streaks or lines are worrisome as they usually indicate a spreading infection that can result in sepsis.

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Comment from: butterfly, 25-34 Female (Patient) Published: April 25

I survived a severe septic shock in September 2013. I originally had vomiting, abdominal pain, temperature, rash, headache, and stiff joints. I was in resuscitation for 12 hours then sent to intensive therapy unit (ITU) where I was put on life support for 7 weeks and needed 8 lots of dialysis, blood and platelet transfusions and medicines to keep my heart going. My family were told I probably wouldn"t survive. But here I am 7 months on and finally getting better.

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Comment from: Jugh, 45-54 Female (Patient) Published: May 01

I had a pancoast tumor (lung cancer) diagnosed in January 2013. I underwent chemo-radiotherapy in the spring of that year with a PET scan in July that showed no cancer left. I was to have surgery to remove the top of my right lung and the dead tumor as soon as I had recovered from the treatment. I woke up one day with the most terrible pain in my ribs on the left side, and feeling freezing cold but sweating. I then started the rigors, this went on for a few days. I was admitted to the hospital and my blood pressure was 65 over 50. I had never felt so ill even through all the cancer treatment, thank goodness they started me on IV metronidazole straight away before they even had any blood cultures back or test results. They said that sepsis was living in the dead tumor. I stayed on metronidazole until I had the surgery in October 2013. Every time I came off it the symptoms would start to return. As soon as they removed the tumor I was fine, I would never want to experience this again.

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