Sepsis

Sepsis is a potentially life-threatening condition that occurs when the body's response to infection causes tissue damage and organ dysfunction. It can result from bacteria, viruses, fungi, or parasites and may affect people of all ages, though older adults and those with chronic illness are at higher risk. If untreated, sepsis can progress to septic shock and death.

Common signs include fever or hypothermia, rapid heart rate, rapid breathing, confusion or agitation, severe weakness, and signs of organ dysfunction such as reduced urine output or shortness of breath.

Pathophysiology involves a dysregulated host response that drives inflammation, coagulation, and impaired blood flow, leading to tissue hypoxia and organ failure.

Diagnosis combines detection of infection with organ dysfunction. Sepsis-3 defines sepsis as an acute increase in the SOFA score of 2 or more due to infection. Quick SOFA uses three bedside criteria: altered mentation, systolic blood pressure ≤100 mmHg, and respiratory rate ≥22. Lactate level indicates severity. Blood cultures and imaging help identify the source.

Management requires prompt treatment: antibiotics started within the first hour of recognition, fluid resuscitation with crystalloids (typically 30 mL/kg for septic shock), and vasopressors to maintain mean arterial pressure ≥65 mmHg if needed. Source control, careful fluid management, and organ support are essential; steroids may be used for refractory shock.

Prognosis varies with severity and comorbidity; septic shock carries higher mortality than sepsis alone. Public health emphasis on infection prevention, vaccination, and early recognition improves outcomes.