Sepsis (Blood Poisoning)
Medical Author: Charles P. Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Neonatal Sepsis (Sepsis Neonatorum)
Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
 Neonatal sepsis is any infection involving an infant during the first 28 days
of life. Neonatal sepsis is also known as "sepsis neonatorum." The infection may
involve the infant globally or may be limited to just one organ (such as the
lungs with pneumonia). It may be acquired prior to birth (intrauterine sepsis)
or after birth (extrauterine sepsis). Viral (such as herpes, rubella [German
measles]), bacterial (such as group B strep) and more rarely fungal (such as
Candida) causes may be implicated.
During her pregnancy, a women's obstetrician is constantly monitoring the
health of both of the pregnant women and her fetus for any signs or symptoms
that might indicate sepsis. Prior to birth, many indicators can signal that a
potential infection is developing. Women are screened for infectious diseases at
their first OB office visit. Some of these include HIV, gonorrhea, syphilis,
herpes, Chlamydia, and hepatitis B, as well as immunity to rubella
and chickenpox. Between the 35th and 37th week of pregnancy, screening for
group B strep is commonly performed. Some symptoms and signs, such as slower
than anticipated fetal growth, may be subtle indications of threatened fetal
well-being. Measurement of uterine size via the traditional tape measure or
ultrasound examination of the uterus, placenta, and fetus will both provide
critical information. Throughout the pregnancy, office visits provide the
opportunity to monitor fetal heart rate. The obstetrician commonly evaluates
both the actual heart rate at rest as well as the infant's cardiac response to a
mild stress (for example, uterine contraction). If concerns develop, specialized
evaluations can be performed ("stress testing") during which fetal heart rate,
fetal movement and fetal tone are monitored and an objective risk assessment may
be made. Maternal fever during her pregnancy warrants a timely and thorough
evaluation. Equally significant would be the onset of premature labor or
premature rupture of the amniotic sac (termed "premature rupture of membranes").
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What is blood poisoning?
Blood poisoning is a nonspecific term used mainly by nonmedical individuals that describes, in the broadest sense, any adverse medical condition(s) due to the presence of any toxic agent in the blood. Usually, the layperson using the term blood poisoning is referring to the medical condition(s) that arise when bacteria or their products (or both) reach the blood.
Blood poisoning is not a medical term and does not appear in many medical dictionaries or scientific publications. However, when it is used, the correct medical term that most closely matches its intended meaning is
sepsis. Many medical authors consider the terms blood poisoning and sepsis to be interchangeable, but the trend is to use the term
sepsis.
What is sepsis?
Sepsis is a potentially dangerous or life-threatening medical condition, found in association with a known or suspected infection (usually but not limited to bacteria) whose signs and symptoms fulfill at least two of the following criteria of a systemic inflammatory response syndrome (SIRS):
- elevated heart rate (tachycardia) >90 beats per minute at rest
- body temperature either high (>100.4F or 38C) or low (<96.8F or 36C)
- increased respiratory rate of >20 breaths per minute or a PaCO2 (partial pressure of carbon dioxide in arterial blood) <32 mm Hg
- abnormal white blood cell count (>12000 cells/µL or <4000 cells/µL or >10% bands
[an immature type of white blood cell])
Patients that meet the above criteria have sepsis and are also termed septic. These criteria were proposed by several medical societies and may continue to be modified by other medical groups. For example,
pediatric groups use the same four criteria listed above but modify the values for each to make the SIRS criteria for children. Other groups want to add criteria, but currently this is the most widely accepted definition.
Terms that are often used in place of sepsis are bacteremia, septicemia, and
blood poisoning. However, bacteremia means the presence of bacteria in the blood; this can occur without any of the criteria listed above and should not be confused with sepsis. For example, you can brush your teeth and get bacteremia for a short time and have no SIRS criteria occur. Unfortunately, septicemia has had multiple definitions over time; it has been defined as bacteremia, blood poisoning, bacteremia leading to sepsis, sepsis, and other variations. Although septicemia appears frequently in the medical literature, a reader must be sure which definition the author is using. Some experts suggest the terms blood poisoning and septicemia not be used since they are poorly defined, but it is difficult to disregard such terms that have been used for many decades.
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MRSA »
What is methicillin-resistant Staphylococcus aureus MRSA?
MRSA stands for methicillin-resistant Staphylococcus aureus (S. aureus)
bacteria. This organism is known for causing skin infections in addition to many
other types of infections. There are other designations in the scientific
literature for these bacteria according to where the bacteria are acquired by
patients, such as community-acquired MRSA (CA-MRSA), hospital-acquired or health-care-acquired MRSA (HA-MRSA), or epidemic MRSA (EMRSA). A number of Web and
popular press articles are titled or include the erroneous term "MRSA virus."
This is a misnomer; there is no contagious MRSA virus, and if readers examine
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Although S. aureus has been causing infections (Staph infections) probably as
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