Sepsis - Symptoms

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What are sepsis (blood poisoning) symptoms and signs?

The adult patient should have a proven or suspected source of an infection (usually bacterial) and have at least two of the following problems to be diagnosed as having sepsis:

  • Altered mental status (for example, altered consciousness, mental confusion or delirium)
  • Fast respiratory rate (> 22 breaths/minute)
  • Low blood pressure (≤ 100 mm Hg systolic)

However, patients may have many other signs and symptoms that can occur with sepsis, such as

  • elevated heart rate (tachycardia),
  • fever,
  • low body temperature (hypothermia),
  • a reduced carbon dioxide (PaCO2) level in the blood,
  • chills,
  • dizziness,
  • fatigue,
  • shivering,
  • facial flushing,
  • shortness of breath,
  • low urine production,
  • skin discoloration,
  • dysfunction of one or more organs,
  • shock,
  • sleepiness.

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, dysuria, 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 100.4 F 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.

Septic shock is a condition in which overwhelming infection causes a dangerous drop in systolic blood pressure (hypotension). Additional symptoms that may accompany the low blood pressure may include cool and pale extremities, dizziness or lightheadedness, low or absent urine output, shortness of breath, rapid heart rate, behavioral changes, and low or high body temperature.

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See what others are saying

Comment from: Xoli, 45-54 Female (Patient) Published: March 31

I had a terrible headache and shivering. I went to the hospital and my temperature was 39 degrees and my blood pressure was very low. They told me that I had sepsis and that worries me. They have given me some antibiotics but I am still not sure what was causing that. I still need to know what cause this sepsis.

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Comment from: losbanosmonkey, 65-74 Male (Caregiver) Published: May 16

My father last year had sepsis. I'm pretty sure he got it from picking up cat turds with his bare hands. I don't know why he did that. He developed flu-like symptoms and I believe a headache. They couldn't identify it at one hospital so he was transferred to another. He lost a lot of weight with his sepsis and was talking crazy (asking me to get him a knife) because he had to be restrained to the hospital bed. They didn't know what to do with him at first. After my mom raised hell on the phone I went to visit him and there were like 20 personnel watching over him. It turns out the thing that saved his life was a blood transfusion.

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