Sepsis – what it is, causes, symptomsadults and treatment

Sepsis is a kind of systemic pathogenetic reaction.
the human body to the introduction of an infectious agent, developing
as a result of the generalization of the infectious inflammatory process
against the background of a marked decline in the function of the immune apparatus.

Blood sepsis: what is it?

сепсис крови

Sepsis (blood poisoning) is a secondary infection.
disease caused by ingress of pathogenic flora from the primary
local infectious focus in the bloodstream. Two-thirds
patients initially go to doctors about other
diseases, and only later they develop sepsis.

Sepsis is a serious illness that is accompanied by
disruption of all organs, poses a threat to life
the patient. Therefore, hospitalization is carried out on a mandatory basis.
Most often, treatment is performed in the surgical department or
intensive care unit.

Sepsis in both children and adults is considered extremely difficult and
a dangerous condition that requires immediate treatment.

Disease classification

The pathogens invade a living organism with various
in ways. Depending on the method of infection, the primary
focus of inflammation. So, in particular, with the bite of an animal, a nidus
inflammation is an injured spot with concomitant
factors.

Forms of sepsis are classified according to location.
primary infectious focus.

Depending on the pathogen emit:

  • staphylococcal,
  • streptococcal,
  • meningococcal,
  • pneumococcal,
  • pseudomuscular,
  • colibacillary,
  • anaerobic sepsis.

Forms:

  1. Lightning form is characterized by a stormy start, very heavy
    current and extremely unfavorable prognosis. Developed in 24-72
    hours
  2. For acute sepsis, events do not develop.
    rapidly (up to a week).
  3. Subacute sepsis can last up to 3 months, or even more,
    of course, its course is not so pronounced;
  4. Chroniosepsis takes quite a long time (up to a year).
  5. Recurrent form – alternating periods of sepsis with
    periods of complete health.

According to the place of penetration of the pathogen and the source:

  • Surgical sepsis, having a source of purulent processes in
    open and closed wounds, complications of external and internal
    ulcers.
  • Postoperative, which occurs after the violation
    aseptic procedures during operations;
  • Obstetric and gynecological sepsis – is a consequence
    complicated childbirth, female genital surgery. Extremely
    such pathology is difficult, resulting in
    clandestine abortions, miscarriages.
  • Urosepsis. The pathogen is actively developing from outbreaks,
    located in the organs of the genitourinary system (urethritis, cystitis,
    Bartholinitis, prostatitis). At the same time one of the characteristic
    features of urosepsis considered mandatory presence
    various inflammatory, purulent foci in the bladder
  • Otogenic sepsis is dangerous, as it can occur
    as a complication of purulent otitis. It often leads to
    spread of infection to the lining of the brain that
    contributes to the development of meningitis.
  • Rhinogenic sepsis is relatively rare,
    characterized by the fact that the primary focus of purulent inflammation
    located in the nose and paranasal sinuses.

The reasons

Sepsis in an adult patient or child develops as a result of
massive infection with toxins and putrid products
destruction of pathogenic microorganisms, when using inadequate
treatment regimens of the underlying disease, that is, this pathology
Experts view the generalization of inflammatory
process.

The diagnosis of sepsis is extremely dangerous for
human condition that often ends in death
the outcome

The development of sepsis may contribute to:

  1. Non-compliance with the rules of asepsis and antisepsis during processing
    purulent wounds, during surgery.
  2. Wrong selection of drugs, an error with the appointment
    dosages of antibacterial drugs.
  3. Immunological disorders.
  4. The progression of infectious pathogens resistant to
    antibiotics.

Diseases that can cause sepsis in humans

Blood sepsis occurs when the balance between protective
силами организма и активностью патогенной микрофлоры. The main
предрасполагающим фактором к развитию септического
состояния считается:

  • Wounds and purulent processes in the skin.
  • Osteomyelitis – purulent process in the bones and red bone
    the brain.
  • Severe sore throat.
  • Purulent otitis media (ear inflammation).
  • Infection during childbirth, abortion.
  • HIV infection at the AIDS stage.
  • Extensive injuries, burns.
  • Infectious and inflammatory diseases of the organs
    urinary system.
  • Infectious and inflammatory diseases of the abdomen,
    перитонит (воспаление брюшины – тонкой пленки, которая
    lines the inside of the abdominal cavity).
  • Глубокий гнойный очаг: фурункул или
    карбункул, послеоперационные абсцессы и гнойники
  • Pneumonia, purulent processes in the lungs.
  • Nosocomial infection. Often in hospitals circulate
    special microorganisms that have become in the course of evolution more
    resistant to various antibiotics negative impacts.

People who suffer are most likely to get sick
chronic diseases, ill for a long time, with exhausted
immunity.

Symptoms of sepsis, photo

фото

The photo shows the first signs of sepsis in an adult.
human

The most dangerous thing during sepsis is the many-sidedness of its symptoms.
In order to diagnose sepsis, there must be at least
two criteria of the following:

  • body temperature more than 38 ° C or less than 36 ° C;
  • heart rate over 90 beats per minute;
  • the number of respiratory movements more than 20 per minute or batch
    carbon dioxide pressure of less than 32 mm Hg;
  • leukocytes more than 12 or less than 4, and immature neutrophils more
    ten%.

The main signs of sepsis:

  • Fever (temperature rises above 38 degrees) or
    hypothermia (temperature below 36 degrees);
  • Heartbeat with a frequency above 90 beats per minute;
  • Rapid breathing (more than twenty per minute);
  • Consciousness, even coma;
  • Leukocytosis or leukopenia in the general blood test;
  • Signs of inflammation in the form of increased C-reactive protein and
    procalcitonin in biochemical analysis;
  • Drop in blood pressure during septic shock;
  • Pallor and marbling of the skin;
  • Perhaps the appearance of a specific rash on the skin and mucous membranes
    shells.

Signs of sepsis in adults

Most often, the symptoms of sepsis in adults develop as a result of
various medical manipulations. It may be operational
interventions, installation of catheters, gynecological manipulations
or injections.

Common symptoms of sepsis in adults:

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  • Weakness and fatigue;
  • Nausea, vomiting, lack of appetite;
  • Headaches, dizziness and loss of consciousness;
  • Tachycardia and interruptions in the work of the heart;
  • Seals or pustules on the skin,
  • Diarrhea and constipation;
  • Unreasonable weight loss;
  • Constant increase in temperature to 37 degrees.

The characteristic kind of patients attracts attention. Face
adults with sepsis: sunken, earthy or yellow skin
colors. A petechial rash may appear on the body. Tongue overlaid
dry bloom.

Сепсис у новорожденных детей

Newborns with sepsis also have such symptoms.
like vomiting, diarrhea. Infants refuse to breast swiftly.
lose weight. Often, suppuration is determined in the navel,
abscesses of various localization are found.

Manifestations of sepsis depend largely on the type of microorganisms,
causing infection. A common symptom is fever,
although in some cases hypothermia is noted. Blood poisoning
often accompanied by increased pulse rate, the appearance of lesions on
skin.

Сепсис у новорожденных

In children, the main symptoms of sepsis:

  • mostly periodic, of the wrong nature of raising
    temperature (alternation of heat with chills with periods of subfebrile,
    rarely normal temperature), often sweat;
  • intoxication (loss of appetite, malaise or
    anorexia, worsening of sleep);
  • discoloration of the skin (pale, gray, earthy), often
    acrocyanosis or cyanosis of the nasolabial triangle, often skin
    rash, often hemorrhagic, dry tongue;
  • increased heart rate;
  • enlarged soft spleen.

Increase the risk of developing sepsis in young children:

  • congenital heart disease, endocarditis;
  • preterm delivery (up to 37 weeks);
  • infections of the ear, respiratory tract;
  • drugs that reduce immunity;
  • large surface burns;
  • age less than 3 months;
  • weak immune system.

When symptoms of sepsis appear in the laboratory, they do
microbiological blood culture, urinalysis. Laboratory
analyzes play a crucial role in confirming or excluding
diagnosis.

Therapeutic measures are aimed at the destruction of the pathogen, on
sanitation of purulent foci and to increase the body’s resistance
baby Breastfeeding is very important. Good
treatment background – quality care for a sick child. To kid
conduct antibiotic therapy (usually combine two or more
antibiotics).

Complications

With the further development of sepsis, various
complications. The most common of these are capillary.
bleeding, pressure sores, vascular thrombosis. DIC, arrhythmias,
gastrointestinal bleeding based on stress factors
intestinal reperfusion, etc. Exodus with complications in most
случаев неблагоприятен и заканчивается летальным the outcome

Diagnostics

Sepsis – which doctor will help? In the presence or suspicion of
development of sepsis should be promptly sought
consultation to such doctors as an infectious disease surgeon,
hematologist.

Recognition of sepsis is based on clinical criteria.
(infectious toxic symptoms, the presence of a known
primary lesion and secondary suppurative metastases), as well as
laboratory indicators (blood culture for sterility).

Can be held:

  • laboratory blood tests (neutrophilic
    leukocytosis with a shift of the leukocyte formula to the left, reducing
    hemoglobin), urine;
  • Ultrasound of the kidneys, liver and other organs;
  • radiodiagnosis;
  • CT scan;
  • ECG;
  • bacterioscopic studies;
  • magnetic resonance imaging.

Differentiate sepsis is necessary from Hodgkin’s disease,
leukemia, typhoid, paratyphoid A and B, brucellosis, tuberculosis,
malaria and other diseases associated with prolonged
fever.

How to treat blood sepsis?

Treatment of sepsis should be started immediately. Most
the main principle – the rehabilitation of the source of infection, which led to
spread of the disease.

All patients with any form of sepsis or even with one suspicion
for this disease are subject to hospitalization. According to indications apply
cardiac and other symptomatic remedies. If the diagnosis is not
It is doubtful that antibiotics are injected intramuscularly (penicillin,
streptomycin, bitsillin, etc.). Carriage in the supine position.

Лечение сепсиса проводится по двум основным
directions:

  • выявление инфекционного агента с назначением специфической
    antibacterial, antifungal or antiviral
    therapy.
  • correction of DIC.

Medications

The patient is prescribed emergency medication:

  • antibiotics;
  • pain medication;
  • immunomodulators;
  • solutions of infusion therapy;
  • drugs that normalize blood pressure;
  • drugs that restore the function of the heart, liver,
    the kidneys;
  • vitamins, antioxidants.

Forecast

It should be noted that sepsis is quite difficult.
The mortality rate depending on the type and nature of the flow can
reach 50%, and with the development of a septic shock this
figure even higher.

Forecast при заражении крови всегда серьезен. With
lightning sepsis lethality is inevitable in 85 – 99%
patients subjected to bacterial aggression.

The disease is most severe in older patients and
newborn babies.

Diet

Patients with sepsis are prescribed a diet and full rest is recommended.
The state of the focus of inflammation is constantly monitored for
timely prevention of acute reactions.

Food for sepsis should be balanced and
easily digestible, and also sufficiently fortified. It is it
along with proper patient care determines the outcome of the treatment.

Prevention

Reliable disease prevention is provided by:

  • patient compliance;
  • timely elimination of local ulcers;
  • strict compliance by health workers with the requirements of asepsis;
  • minimum periods of use of catheters;
  • competent antibiotic therapy;
  • vaccination of problem patients.

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