Szepszis

Szepszis, or sepsis, is a life-threatening condition defined as organ dysfunction caused by a dysregulated host response to infection. It arises when the body's reaction to an infection injures its own tissues and organs, potentially leading to septic shock and death if not treated promptly.

Most cases are caused by bacterial infections, but viruses, fungi, and parasites can also trigger szepszis. The pathophysiology involves excessive inflammation, immune dysregulation, coagulation abnormalities, and impaired blood flow, which can cause multiple organ dysfunction, including the lungs, kidneys, liver, and brain. Septic shock is a subset characterized by persistent low blood pressure despite fluid resuscitation and the need for vasopressor support.

Common signs include fever or low temperature, rapid heart rate, rapid breathing, confusion or reduced alertness, severe shortness of breath, clammy or mottled skin, and reduced urine output. Diagnosis relies on suspected infection plus evidence of organ dysfunction. Laboratory tests may show elevated lactate, abnormal white blood cell counts, impaired kidney or liver function, and positive cultures. Imaging and other tests help identify the source. In many guidelines, sepsis is defined by an acute change in the SOFA score of 2 points or more in the context of infection.

Treatment requires rapid action: broad-spectrum antibiotics started within the first hour, intravenous fluids (crystalloids) for perfusion, and vasopressors if shock persists. Supportive care includes oxygen therapy, glucose control, and management of organ support as needed, along with source control of the infection.

Prevention focuses on infection control, vaccination, timely treatment of infections, and antibiotic stewardship. Outcomes vary with age, comorbidities, and the timeliness of treatment; early recognition improves survival.