Think of sepsis as a hidden danger. It claims about 350,000 lives in the U.S. each year and is responsible for nearly one-fifth of deaths worldwide. Yet, you won’t see it listed among the “leading causes of death.” That’s somewhat surprising.
Sepsis typically begins as something else—like infections in the lungs, skin, or urinary tract. These usually resolve on their own. However, when the body reacts excessively to an infection, damaging organs in the process, that’s when sepsis sets in.
One of the tricky parts about sepsis is that early symptoms can be quite vague. Many people might not even realize what’s happening until they deteriorate further.
“There’s not a typical presentation like a heart attack or stroke; it can be quite subtle,” explains Dr. Francis Castiller, a critical care physician at UNC Health, who specializes in treating sepsis in the ICU.
What is sepsis, and who gets it?
When we contract infections, it’s usually due to pathogens—typically viruses or bacteria—entering our bodies. Our immune systems respond by sending out cells to combat the invaders, and these cells release “inflammatory mediators” aimed at attacking the pathogens.
“Sometimes these inflammatory agents can become overly aggressive, leading to harm to our own organs,” Dr. Castiller notes.
Almost any infection, from a simple skin cut to COVID-19, can lead to sepsis. Frequently, it arises from infections in the lungs, urinary tract, skin, or gastrointestinal tract.
While anyone can develop sepsis, older adults (especially those over 65), individuals with weakened immune systems, and those with serious underlying conditions like diabetes or vascular disease are at increased risk. Infants under one year old are also more vulnerable.
If sepsis goes untreated or antibiotics fail, it can escalate to septic shock, characterized by critically low blood pressure and potential organ failure. The mortality risk from sepsis without shock is around 12 to 15 percent, but it skyrockets to as high as 45 percent with shock, according to Dr. Castiller.
Interestingly, sepsis isn’t something you “catch” in the hospital environment, yet one in three hospital deaths involves sepsis. It’s a common yet dangerous condition.
Treat sepsis quickly to improve chances of survival
Timely treatment is crucial for survival, but it can be tricky because awareness is low and symptoms can differ widely from person to person, Dr. Castiller explains.
“There’s no one specific symptom to point to,” he says. “If your loved one doesn’t seem quite right, whatever that might mean, it’s best to consult a healthcare provider quickly. Early detection makes a huge difference in managing sepsis.”
For infants, the advice is similar: if your baby isn’t eating or sleeping normally, or appears lethargic, reach out to your pediatrician immediately.
Doctors should be alert to sepsis if two of the following three signs are present: low blood pressure, rapid breathing, and confusion, Dr. Castiller suggests.
Treatment typically involves administering antibiotics and IV fluids to help maintain organ function. Sometimes, multiple antibiotics are necessary.
If a loved one has an infection that’s not improving, don’t hesitate to ask their doctor or nurse about the possibility of sepsis.
Life after sepsis
Sepsis can leave lasting impacts on the body, even after the underlying infection resolves. Survivors may experience physical and mental effects, such as ongoing fatigue, sleep difficulties, anxiety, and depression.
Depending on the severity of the illness, certain organs might not function as they did before. For instance, a person who had sepsis due to a kidney infection could face ongoing kidney issues.
Fortunately, “for most individuals, the organ dysfunction is reversible,” Dr. Castiller states.
Many survivors find rehabilitation and physical therapy helpful. Those struggling with mental health issues related to sepsis, including post-traumatic stress disorder, may benefit from consulting a psychologist.
It’s vital for survivors to understand they’re at an elevated risk for experiencing sepsis again, according to Dr. Castiller.
“We need to continue raising awareness so sepsis can be recognized and treated early. That’s the most effective way to save lives,” he emphasizes.
