Sepsis - what is it? Causes, Symptoms and Treatment

Sepsis Sepsis is a serious infectious disease that develops as the infection progresses and spreads through the body through the blood. Hippocrates, 2000 years ago, called sepsis a disease with tissue decay and putrefaction, without treatment inevitably leading to death.

Most often the causative agents of sepsis are staphylococci, E. coli, streptococci, pneumococci. Sepsis often develops due to the unfavorable course of purulent inflammation of soft tissues (abscess, peritonitis), against the background of weakening of the body's defenses.

Causes of sepsis

Why sepsis develops, and what is it? The causative agents of sepsis are pathogenic fungi and microbes. The mainmicrobial agents are generally considered:

pneumococcus, Klebsiella, meningococcus;
Pseudomonas aeruginosa, pathogenic strains of staphylococcus;
tuberculous mycobacterium;
pathogenic strains of Escherichia coli.

Causes of infectionthroughout the body:

extensive spread of antibiotic-resistant strains;
presence of concomitant pathology;

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impaired immunoreactivity;
illiterate choice of symptomatic, detoxification treatment and antibiotic therapy;
inadequate volume of surgical operations and illiterate surgical tactics.

Usually,sepsis occurs when:

immunodeficiency and rickets;
diabetes;
oncological diseases;
with severe burns and injuries;
long-term administration of immunosuppressors.

Not in every case, the infection, even highly aggressive, can result in sepsis. Moreover, initially a healthy person more often copes (not without the help of drugs) with the disease without experiencing the terrible consequences of its spread.

Contribute to the development of sepsis associated chronic diseases, trauma, bleeding, pulling a part of the protective forces. The immune system is compelled to constantly struggle with the focus of chronic inflammation (bronchitis, colitis, caries etc.) and sometimes remaining "in the line" of forces is not enough to cope with the new plague.

Classification

Depending on the time of the current:

Lightning fast (sharpest). All the symptoms arise and grow very quickly. The work of internal organs is severely disrupted. The patient's condition deteriorates rapidly. Even after 1-2 days death may occur.
Acute. Symptoms grow slower the disease lasts up to 6 weeks.
Subacute. Leaks, as a rule, from 6 weeks 3-4 months.
Recurrent. It lasts up to six months and longer. To replace the improvement of the patient's condition new exacerbations come - the disease proceeds undulating.
Chroniosepsis (chronic sepsis). It continues for a long time, for several years.

There are several types of sepsis, differing in the mechanism of development and types of pathogens:

Most often occurssurgical sepsis. Its causes are complications of various surgical purulent diseases or injuries (wounds, burns, etc.).
Obstetrical and gynecological sepsiss has two periods - intrauterine and postpartum (for reasons of septic diseases of the medical staff or the mother). This infection is very dangerous, as it is transmitted through various objects and can enter the body through the wound, by the respiratory route, through the skin or baby food. The suppuration occurs at the site of infection.
Otogenic sepsisis dangerous, since it can occur as a complication of purulent otitis media. It often leads to the spread of infection on the membranes of the brain, which contributes to the development of meningitis.
Rhinogenic sepsissometimes associated with complications of purulent diseases of the nose and paranasal sinuses.
Urosepsisoccurs with inflammation of the urogenital system (urethritis, cystitis, pyelitis, nephritis, bartholinitis, prostatitis).

Depending on the changes occurring in the body:

Septicemia- a condition in which the general condition of the body is disturbed, a systemic inflammatory reaction arises in it, but there are no foci of suppurative inflammation in the internal organs. This form is most often acute or lightning fast.
Septiccopymia- a form of sepsis, in which abscesses form in different organs.
Septic endocarditis- a kind of septicemia, in which the focus of inflammation is on the surface of the valves of the heart.

Symptoms of sepsis

With the development of sepsis, the course of symptoms can be fulminant (rapid development of manifestations within 1-2 days), acute (up to 5-7 days), subacute and chronic. Often, there are atypical or "worn out" symptoms (so, in the midst of the disease, there may not be a high temperature), which is associated with a significant change in the pathogenic properties of pathogens as a result of the massive use of antibiotics.

Symptoms of sepsis largely depend on the primary focus and type of pathogen, but for a septic process there are several typical clinical symptoms:

severe chills;
increase in body temperature (constant or wavy, associated with the introduction of a new portion of the causative agent into the blood);
strong sweating with the change of several sets of laundry per day.

These are the three main symptoms of sepsis, they are the most constant manifestations of the process. In addition, they can be:

Herpes-like eruptions on the lips, bleeding mucous;
impaired breathing, decreased blood pressure;
seals or pustules on the skin;
decrease in the volume of urine;
pallor of the skin and mucous membranes, waxy complexion;
fatigue and indifference of the patient, changes in the psyche from euphoria to violent apathy and stupor;
sunken cheeks with a pronounced blush on the cheeks against a background of general pallor;
hemorrhages on the skin in the form of spots or striae, especially on the hands and feet.

It should be noted that with any suspicion of sepsis, treatment should begin as soon as possible, since the infection is extremely dangerous and can lead to death.

Sepsis in the newborn

The incidence of neonatal sepsis is 1-8 cases per 1000. Mortality is quite high (13-40%), therefore, for any suspicion of sepsis, treatment and diagnosis should be carried out as quickly as possible. In the group of special risk premature babies come, because in their case the disease can develop at a lightning speed because of weakened immunity.

With the development of sepsis in newborns (source - purulent process in the tissues and vessels of the umbilical cord-umbilical sepsis) are characterized by:

vomiting, diarrhea,
full refusal of the child from the chest,
rapid weight loss,
dehydration; skin covers lose elasticity, become dry, sometimes earthy in color;
it is often determined local suppuration in the navel, deep phlegmon and abscesses of different localization.

Unfortunately, the mortality of newborns in sepsis remains high, sometimes reaching 40%, and with intrauterine infection even more (60-80%). Survivors and children who have recovered are also having a hard time, because they will be accompanied by such consequences of sepsis as their life:

weak resistance to respiratory infections;
pulmonary pathology;
heart diseases;
anemia;
delay in physical development;
damage to the central system.

Without active antibacterial treatment and immunocorrection, one can hardly expect a favorable outcome.

Diagnostics

The examination for sepsis is prescribed in accordance with the form of the disease and the localization of the septic focus. Can be conducted:

laboratory blood tests (neutrophilic leukocytosis with a shift of the leukocyte formula to the left, a decrease in hemoglobin), urine;
Ultrasound of the kidneys, liver and other organs;
X-ray diagnostics;
CT scan;
ECG;
bacterioscopy studies;
magnetic resonance imaging.

It is not always easy to diagnose blood poisoning. It often happens that the primary focus is not defined. The disease has a "worn out" picture.

Complications

The main complications of sepsis are associated with multiple organ failure (renal, adrenal, respiratory, cardiovascular) and DIC syndrome (bleeding, thromboembolism).

The severest specific form of sepsis is a septic (infectious-toxic, endotoxic) shock.

How to treat septicemia?

In the case of sepsis, a complex treatment is prescribed. Physicians must necessarily take into account the high risk of death and the development of serious complications.

The scheme of measures in the treatment of sepsis includes:

antibiotic therapy- use of antibacterial drugs that destroy the pathogen;
immunotherapy- use of drugs that increase the body's defenses;
use of medicines thateliminate the symptoms of sepsis, disorders in the body, restore the work of internal organs;
surgery- elimination of purulent foci in the body.

When treating sepsis, the patient is prescribed an easily digestible, balanced diet. In the diet, proteins of animal origin, carbohydrates and sugar predominate. On the patient's table daily fresh vegetables and fruits, lean meat, fish, as well as dairy products, including cottage cheese, cheese and butter should be present. Also, the patient should drink at least 2 liters of fluid per day. It is better if it is fruit and vegetable juices, mineral water and green tea.

Forecast

With any form of sepsis, the prognosis is always serious. The earlier treatment is initiated, the higher the probability of complete recovery. The complexity of diagnosis and treatment of sepsis is the presence of a large number of erased forms, when the clinical picture is not so bright.

Prevention

Preventive measures against sepsis consist in elimination of foci of purulent infection; correct management of burns, wounds, local infectious and inflammatory processes; observance of aseptic and antiseptic when carrying out medical-diagnostic manipulations and operations; prevention of hospital infection; vaccination (against pneumococcal, meningococcal infection, etc.).