Sepsis, the body’s extreme and potentially life-threatening response to an infection, has drawn renewed public attention following the death of NASCAR driver Kyle Busch at age 41.
Dr. Taison Bell is the interim chair of medicine at the University of Virginia School of Medicine and a specialist in infectious diseases and critical care. (Contributed photo)
While sepsis can develop rapidly and become deadly if not treated quickly, many people do not recognize the warning signs until it becomes severe. Dr. Taison Bell, interim chair of medicine at the University of Virginia School of Medicine and a specialist in infectious diseases and critical care, breaks down what people should know about sepsis, how to reduce the risk and why early treatment is critical.
Q. What exactly is sepsis, and why can it become life-threatening so quickly?
A. Sepsis is when the body’s normal response to an infection becomes exaggerated and dangerous. Normally, the immune system fights germs in a controlled way with a combination of the innate system (physical barriers and rapid-response cells) and the adaptive system (targeted white blood cells that attack germs and build memory). In sepsis, that response becomes dysregulated and starts damaging the body’s own organs and tissues.
What makes sepsis so dangerous is how fast it can progress. An infection that starts in the lungs, urinary tract, skin or abdomen can quickly trigger widespread inflammation, low blood pressure, poor blood flow and organ failure. If blood pressure drops severely and organs stop getting enough oxygen, the condition is called septic shock, which carries an even higher risk of death.
Doctors consider sepsis a medical emergency because early treatment – especially fluids and antibiotics – can significantly improve survival.
Q. What are the warning signs people should watch for?
A. Sepsis can look different from person to person, but some warning signs are especially important in people who have an infection:
- Fever, chills or feeling extremely cold
- Fast heart rate
- Rapid breathing or shortness of breath
- Confusion, trouble thinking clearly or unusual sleepiness
- Extreme weakness or severe pain
- Low blood pressure, dizziness or fainting
- Bluish or mottled skin
- Decreased urination
The key concept here is that the response to infection has led to detriment in the body’s normal function – in other words, someone with an infection who suddenly seems much sicker than usual. Sepsis symptoms can worsen over days and even hours. If someone with an infection becomes confused, struggles to breathe or looks severely ill, they should seek emergency care immediately.
Bell says sepsis can begin with common infections, but quickly become life-threatening if warning signs are missed. (University Communications photo)
Q. Who is most at risk for sepsis? Can healthy people get it too?
A. Certain groups are at especially high risk:
- Older adults
- Infants and very young children
- People with weakened immune systems
- People with cancer, diabetes, kidney disease or lung disease
- People recovering from surgery or major injuries
- Hospitalized patients, especially those with IV lines or catheters
However, healthy people absolutely can also develop sepsis. Even a routine infection like pneumonia, influenza, COVID-19, a urinary tract infection or a skin infection can occasionally trigger sepsis in someone with no major medical problems.
According to newly published sepsis guidelines, there are an estimated 49 million cases of sepsis worldwide each year and about 13 million sepsis-related deaths.
Q. What can people do to prevent sepsis or lower their risk after an infection?
A. Many cases of sepsis can be prevented by reducing the chance of serious infection and treating infections early. I break these down into stacking the deck in your favor and seeking treatment as soon as possible when you have symptoms that are worsening.
Stack the deck:
- Vaccines save lives. Stay up to date on vaccines (flu, COVID-19, pneumococcal)
- Wash hands regularly
- Proper wound care and cleaning cuts promptly
- Managing chronic illnesses like diabetes
- Seeking medical attention for infections that are rapidly worsening
- Taking antibiotics exactly as prescribed
Seek help: Pay attention if an infection suddenly seems “out of proportion.” For example:
- Fever plus confusion
- A skin infection spreading rapidly
- Severe weakness or trouble breathing
- Persistent low blood pressure or fainting
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