Sepsis

Sepsis is a potentially life-threatening condition that arises when the body's dysregulated response to infection causes injury to its own tissues and organs. This initial stage of sepsis is followed by dysregulation of the immune system. Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection. The very young, old, and people with a weakened immune system may not have any symptoms specific to their infection, and their body temperature may be low or normal instead of constituting a fever. Severe sepsis may cause organ dysfunction and significantly reduced blood flow. The presence of low blood pressure, high blood lactate, or low urine output may suggest poor blood flow. Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement or requires medications to raise the blood pressure. Sepsis is caused by many organisms, including bacteria, viruses, parasites, and fungi. Gram-negative and Gram-positive bacteria are the most common causes of sepsis; when caused by bacteria, it is also referred to as septicaemia. Viral pathogens and diarrhoeal illnesses are common causes in children. In 60–70% of cases, an infectious pathogen is found. Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs. Risk factors include being very young or old, a weakened immune system from conditions such as cancer or diabetes, major trauma, and burns. A shortened sequential organ failure assessment score (SOFA score), known as the quick SOFA score (qSOFA), has replaced the SIRS system of diagnosis. qSOFA criteria for sepsis include at least two of the following three: increased breathing rate, change in the level of consciousness, and low blood pressure....