By Oge Okafor
([email protected])
It’s relatively unknown as one hardly ever hears about it and in fact, this little known disease accounts for 4 in 10 hospital deaths. Sepsis, commonly called blood poisoning or septicaemia is a common affliction that can affect people of all ages.
Dr Gabriel Omonaiye defines sepsis as the systemic response to microbial invasion. It’s a potentially life-threatening complication from an infection or condition triggered by an infection or injury.
In sepsis, the body’s immune system goes into overdrive as it tries to fight an infection. It occurs when chemicals released into the blood stream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail. This can reduce the blood supply to vital organs such as the brain, heart and kidneys.
Simply put, sepsis is a life-threatening illness caused by your body’s response to an infection. Your immune system protects you from many illnesses and infections but it is also possible for it to go into overdrive in response to an infection.
Sepsis develops when the body has an overwhelming and life-threatening response to infection. It can cause tissue damage, organ failure and death. It can develop very quickly and be confused with other conditions in the early stages, making it difficult to diagnose.
However, when it occurs, time is of the essence as it’s a medical emergency and prompt diagnosis and treatment saves life. Without quick treatment, sepsis can lead to multiple organ failure and death.
According to the Global Sepsis Alliance, a worldwide alliance of health care providers working to increase knowledge about the ailment, majority of sepsis cases are caused by common infections. Pneumonia, urinary tract infections, skin infections and infections in the abdomen (such as appendicitis) can cause sepsis as well as invasive medical procedures like the insertion of a catheter into a blood vessel. The alliance says sepsis is the primary cause of death from infection, despite advances in modern medicine like vaccines, antibiotics and intensive care.
Why is sepsis deadly one might ask? The symptoms are many and varied, depending on the person in question, the underlying diseases and the severity of the sepsis. Beyond doubt, sepsis is a killer especially in the neonates and pregnant women with prolonged obstructed labour.
The chemical response to microbial invasion can cause deformation, organ damage and death.
The failure of counter regulatory mechanism and dysfunction of major organs occur in severe sepsis.
The microorganism can be gram positive or gram negative or polymicrobial or fungi.
Sepsis is a “common” disease that occurs relatively often and affect individuals of all ages. The illness can quickly evolve from being relatively mild to life-threatening. With a mortality rate of over 10 percent, sepsis is among the seven most common causes of death in North America and parts of Europe. Mortality increases further for every hour the patient goes without treatment in the form of antibiotics and fluids. It is therefore vital to identify sepsis early and start treatment quickly.
Sepsis is a very common and serious condition that many people die from. Anyone can develop sepsis, but it is most common and most dangerous in older adults or those with weakened immune systems. The predisposing factors to the development of sepsis are the extremes of age (the very young and the aged), diabetes mellitus, alcoholism, HIV infection, cancer and cancer therapy, burns, malnutrition, invasive procedures, vascular cathetherization, intravenous dwelling catheter and renal failure.
Patients with lifestyle diseases like diabetes or cancer are particularly at risk. However, sepsis is not as easy to detect as lifestyle diseases and it doesn’t attract nearly as much attention.
In USA, sepsis contributes to greater than 100,000 deaths annually. The factors implicated in sepsis include bacterial endotoxins,tumour,necrotic factors and cytotoxins.
The clinical features include fever or hypothermia, fast and rapid breathing, increased heart rate, low blood pressure (hypotension), nausea, diarrhoea, vomiting, confusion, disorientation, skin rashes, upper gastrointestinal bleeding from stress, ulcers, coma and the features of any underlying sickness.
Sepsis is often diagnosed based on simple measurement like temperature, heart rate and breathing rate and may require a simple blood test. Other tests that can help determine the type of infection, where it’s located and which body functions have been affected are urine/stool samples, a wound culture (where a small sample of tissue, skin or fluid is taken from the affected area for testing), respiratory secretion ( taking a sample of saliva, phlegm or mucus), blood pressure test and imaging studies ( X-ray, ultrasound scan or computerised tomography (CT) scan.
If detected early and hasn’t affected vital organs yet, sepsis may be possible to treat at home with antibiotics and most people treated at this early stage make full recovery.
Almost all people with severe sepsis and septic shock require admission to hospital. Some may require admission to an intensive care unit ( ICU).
Among medical doctors, the awareness of sepsis is very high. The low level of its awareness among the general populace is due to the high level of health illiteracy in our society.
Preventive measures include seeking adequate medical treatment and compliance in diabetics(especially those with leg ulcers and people with injuries), adequate and hygienic management of labour/delivery and burns cases. Hospitals should have up to date anti-septic protocols.
The rate of sepsis is expected to increase in future and fueled by the double problem of increasing incidences of lifestyle diseases and antibiotic-resistant bacteria. For that reason, hospitals should have a standardized observation regime so sepsis can be diagnosed early in its progression and should create clear treatment plans for addressing it.