The recent passing of NASCAR Cup Series champion Kyle Busch, who suffered from severe pneumonia that escalated into sepsis, has reignited discussions around a condition many recognize but few truly understand.
Sepsis is more prevalent and unpredictable than many people might think.
As a urologist, I often encounter patients in the emergency room with infected kidney stones. Strangely enough, symptoms often begin days before: flank pain, fever, chills, nausea, or just an overall sense that something’s a bit off. By the time these patients arrive at the ER, some appear visibly unwell—elevated heart rates, low blood pressure, fatigue, and occasionally confusion.
This situation signifies much more than a typical infection; it showcases sepsis—an extreme response of the body to an infection.
Pneumonia isn’t the only infection that can trigger sepsis. For instance, a rapidly spreading skin infection may prompt an increased heart rate, or a urinary tract infection may lead to a sudden drop in blood pressure. An infected kidney stone that elevates your body temperature signifies that these are not just infections; they could indeed indicate sepsis.
Annually, about 1.7 million adults in the United States develop sepsis, with at least 350,000 dying in hospitals or being discharged to hospice care, according to the CDC. Sepsis contributes to more than one-third of hospital fatalities in the U.S.
Yet, awareness surrounding this issue remains alarmingly low. Many still don’t recognize the signs or understand that ordinary infections can lead to this serious condition.
When a medical team suspects sepsis, time becomes crucial. We administer IV fluids and broad-spectrum antibiotics within the first hour and then scavenge for the source of the original infection.
I’ve witnessed patients walk in barely coherent, only to be sitting up and asking for water a few hours later. But not every case proceeds smoothly. Some patients can arrive early, get aggressive treatment, and still end up in the ICU.
The unpredictable nature of sepsis underscores the importance of recognizing it quickly.
What sepsis does to the body
Many associate infections with being localized—like pneumonia targeting the lungs or a urinary infection affecting the bladder. Sometimes, that observation holds true. But when sepsis develops, the body’s response can outgrow the initial infection.
Think of it like a kitchen fire triggering sprinklers across an entire building. The initial problem can originate in one area, but then the emergency response may extend far beyond expectations or necessity. The body attempts to contain the threat; however, in certain cases, the inflammatory response expands sufficiently to cause a drop in blood pressure, diminished oxygen levels, and potential organ failure.
This is what makes sepsis so perilous. The importance of the infection itself pales in comparison to the body’s response, which often proves even more critical.
Though Busch’s death has spotlighted pneumonia, it represents just one of many potential triggers for sepsis.
Pneumonia arises when an infection and inflammation compromise the lungs, impairing oxygen circulation throughout the body. Generally, many cases improve with treatment, allowing for a typical recovery. However, severe pneumonia can escalate and, in certain situations, lead to sepsis.
Sepsis can also arise from urinary infections, kidney stones, abdominal issues, skin wounds, and surgical sites.
In urology, infected obstructed kidney stones serve as particularly dangerous examples. Bacteria can become trapped behind a blockage, making it difficult for the body to eliminate the infection independently. There was a notable case last year when Billy Porter mentioned going septic following a kidney stone incident, highlighting how quickly this condition can escalate.
Each person reacts differently to infections. Factors such as age, underlying health conditions, and immune response play a role, but they don’t account for everything.
Most sepsis cases occur in individuals with at least one risk factor—older adults, infants, those with chronic conditions like diabetes or cancer, weakened immune systems, or anyone recently hospitalized or recovering from surgery. The CDC notes that roughly one in five sepsis hospitalizations relates to cancer.
This complexity is why it can be difficult to make blanket assumptions about public accounts regarding sepsis; it’s easy to presume that someone overlooked symptoms or received improper care. While those scenarios do occur, sepsis can also develop even with timely assessment and treatment.
Hindsight tends to cloud judgment. We’re often inclined to underestimate symptoms; physicians are no exception.
I recall a time when I ignored severe flank pain due to kidney stones and tried to push through it longer than necessary, ultimately landing in the emergency room. Thankfully, it didn’t escalate into sepsis, but it certainly could have. I was fortunate that things turned out alright, yet the experience served as a reminder of how easily one can convince themselves that symptoms will magically resolve.
Once sepsis is suspected, timing is everything. That’s why emergency departments adhere to protocols designed for quick identification and treatment.
Medical teams are swift to perform blood tests, check for organ dysfunction, start IV fluids and antibiotics, and identify the infection source through cultures or imaging.
Addressing the source is equally as important as combating the infection. Often, this involves draining an abscess, removing infected tissue, or placing a stent in a blocked kidney to allow urine and infection to flow out.
The objective is to manage both the infection and the immune response before it overwhelms the entire system.
Even when treatment is effective, sepsis can leave a lasting impact. One detail that takes many patients and families by surprise is that sepsis can have lingering effects.
While many make a full recovery, up to half of survivors face what is known as post-sepsis syndrome. This condition can manifest as ongoing fatigue, sleep difficulties, trouble concentrating, anxiety, and recurring infections, with effects lasting months or even years. Survivors also face heightened risks of developing heart and kidney issues, according to the CDC.
Therefore, early identification of sepsis is crucial—not only for survival but also for what follows. From what we see daily in medicine, the patients who fare best long-term are typically those who received prompt treatment.
My intent isn’t to frighten anyone facing a cough or mild discomfort. The truth is, most infections don’t escalate to life-threatening levels. However, persistent or worsening symptoms definitely warrant further examination.
A useful memory aid comes from Sepsis Alliance, which employs the acronym TIME:
T: Temperature – whether it’s higher or lower than normal.
I: Infection – any signs of one.
M: Mental decline – confusion, drowsiness, difficulty waking.
E: Extremely ill – experiencing severe pain, shortness of breath, or an overwhelming sense that something is amiss.
If you or a loved one has an infection accompanied by confusion, a racing heart, shortness of breath, or an inexplicable feeling of illness—do not hesitate. Seek emergency care immediately.
Sepsis is swift. Those who survive it are typically the ones who reached the hospital quickly.
