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),
- low body temperature (hypothermia),
- a reduced carbon dioxide (PaCO2) level in the blood,
- facial flushing,
- shortness of breath,
- low urine production,
- skin discoloration,
- dysfunction of one or more organs,
- shock, and
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 PaCO2 (carbon dioxide levels in the blood) and acidosis (measurement of low blood pH) 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 (possible puerperal sepsis due to infection in her reproductive tract) 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 associated with septic shock 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.