Beware of signs and symptoms of sepsis

If you’ve watched enough episodes of “Grey’s Anatomy” then you’ve probably seen that some patients develop sepsis and die.

Dr. Barath Rangaswamy, of the Texas Tech University Health Sciences Center, said the word sepsis itself can provide the warning signs for what can be a mortal condition. S: Shortness of breath; E: Extremely cold hands or feet; P: Palpitations, a racing heart; S: Slurred speech; I: I have never felt so bad; S: Shivering uncontrollably.

“Sepsis is an overwhelming body reaction for any infection and sepsis is a life-threatening condition,” Rangaswamy said. “If not diagnosed early and not treated, it can cause significant mortality and morbidity. Some quick facts about sepsis in America: Around 1.47 million people have sepsis every year. Sepsis, when it gets most severe, which we call septic shock, it has a 30 to 60 (percent) of death rate … One in three deaths that happen in a hospital setting is related to sepsis. So, sepsis needs a significant awareness among public as well as the general practitioners (and) health care workers, to prevent the damage.”

Any infection can cause sepsis, he said. When a bacterial infection goes untreated, most commonly, it progresses into sepsis. Viral infections, such as COVID-19 and fungal infections can also progress into sepsis.

“Any infection which is uncontrolled can progress into sepsis,” said Rangaswamy, who is an assistant professor and assistant clerkship director at the health sciences center.

He added that sepsis can occur at any age.

“Even young and healthy people can have an infection that is uncontrolled. It goes on into severe sepsis and septic shock,” he said. “But the most vulnerable patient population is (the) elderly — age 65 and older — and people who have a weakened immune system. For example, patients with cancer, patients who are on chemotherapy for cancer, which weakens the immune system, patients with chronic medical conditions — diabetes, especially when it is uncontrolled, chronic lung conditions — COPD, asthma — (and) chronic kidney disease: These are the patient populations who are at risk for sepsis.”

“What happens in sepsis is your normal body’s immune response goes into a chain reaction. … It causes a lot of harmful things. (Your) blood pressure is going to drop down to dangerous levels because your blood circulation can be affected, organ systems can get affected,” he added. “You can have organ failure, tissue damage. You might have heard about patients with sepsis losing their limbs … so those things can happen due to less blood supply. Those are some of the manifestations of sepsis.”

The common symptoms of sepsis are increased heart rate, fever, cold and clammy skin, shortness of breath or rapid breathing, confusion or disorientation. A common misconception among the public is that sepsis means bacteria in the blood, but any infection can cause sepsis, Rangaswamy said.

A skin, lung or urinary tract infection can progress into sepsis. Rangaswamy added that health care providers need to diagnose the ailment as soon as possible and get people into the hospital to prevent death.

”Some of the symptoms mimic a bad flu. So sometimes you may think that I’m just having a bad flu and you may just keep pushing through without getting proper medical attention,” he said. “When your flu is not getting better the second day and third day, when you start getting new symptoms — shortness of breath, palpitations, hands and feet becoming cold and clammy and you get confused — those are the warning signs you need to go to the doctor or call 911 to get yourself checked out.

“Why is it so important that we need to get ahead of sepsis? Timely management includes timely antibiotics, every hour counts. Every hour we delay administration (of antibiotics) increases the death rate in sepsis. When the patient comes to the hospital, the doctors are going to give them antibiotics mostly through (an) IV so that it acts faster. They’re going to give them IV fluids. They’re going to check the blood and test for any bacteria. They may check any of their body fluids to check for any infection. There are some sophisticated blood tests to rule out infection. Those (tests) need to be done in a timely manner and the antibiotics need to be administered in a timely manner to prevent that.”

He emphasized that people should take any infection seriously.

“If you have any suspicion (that) the infection is not getting better it’s not a good idea to sit on that and push through and wait for a longer time until it gets worse. That’s when bad things happen,” he said. “So early medical attention is crucial. Prevention is better than cure. Vaccination cannot cure sepsis, but it can potentially prevent the diseases which can progress into sepsis, for example, flu (and) pneumonia shots. Getting those vaccinations helps us (get) ahead of sepsis.”

Practicing good hygiene, including handwashing and proper dental hygiene, are also important, Rangaswamy said, adding that when a dental infection occurs, there is a risk it could progress into a dental abscess which could eventually lead to further serious infection.

And he said if you have an underlying health condition like uncontrolled diabetes, you’re at even higher risk.

“So preventing infection in the first place, and if the infection happens, taking care of the infection, timely and (correctly),” he said. “Do not self-administer or self-medicate yourself with antibiotics. I’ve seen this sometimes — self medicating, with leftover antibiotics and self-medicating with antibiotics which are acquired from unauthorized resources. In the United States, you cannot get an antibiotic without a prescription from a licensed medical provider. It is not so in other places outside of the United States.”

Rangaswany said improper use of antibiotics can not only cause risk of infection, but it can also put the community at risk for antibiotic resistance and “superbugs.”

If you have a wound, keep it clean until it heals.

“When you have an infection, ask yourself is this going to progress to sepsis?” and ask your healthcare provider, he said, adding those with chronic conditions need to take care of them.

Rangaswamy noted that these are things patients can follow to avoid sepsis.

“If we get ahead of sepsis, and if we create enough awareness among the general public and general practitioners about sepsis, we can together conquer sepsis,” Rangaswamy said.