HomePatientsLung Disease Week at the ATS2011Sepsis ▶ General Information About Sepsis
General Information About Sepsis


What is sepsis?  Sepsis, commonly referred to as “blood poisoning,” is toxic response to infection that kills 215,000 Americans each year. It is a medical emergency that requires early detection and treatment for survival.  The infection activates the body’s immune system and sometimes the inflammatory response is so powerful that it causes more harm than good.  Sepsis affects millions of people each year.  People with severe sepsis are very ill and require treatment in the hospital. Sepsis is defined as severe when these findings occur in association with signs of organ dysfunction, such as hypoxemia, oliguria, lactic acidosis, elevated liver enzymes, and altered cerebral function.  Even with the best treatment, severe sepsis is often fatal.  In fact, sepsis is the tenth-most-common cause of death in the United States and is the third leading cause of death in the medical intensive care unit (ICU).  Many people who develop sepsis will also develop corresponding lung, kidney, and/or liver failure. 

If severe sepsis is accompanied by low blood pressure (hypotension) or insufficient blood flow (hypoperfusion) to one or more organs, this is termed septic shock.  Because these patients’ bodies are not receiving enough oxygen, they are very ill and require aggressive treatment in the ICU.  The death rate from septic shock, almost 50%, is even higher than that of severe sepsis.

Who is at risk?  In community-dwelling patients, sepsis often begins as a bacterial infection of the urinary tract, lungs, or skin.  In hospitalized patients, sepsis often begins as an infection involving an intravenous line place in one of the large veins called a central venous line, a catheter placed in the bladder, a breathing tube placed in the lungs, or at the site of surgical wounds.  In up to 1/3 of patients with severe sepsis the cause is unknown. 

While sepsis can occur in anyone, people at higher risk include those who: 

  • Are very young or very old
  • Have a weakened immune system because certain medications used to treat cancer (e.g. chemotherapy) or chronic inflammatory conditions (e.g. corticosteroids)
  • Have wounds or injuries, particularly from burns, severe trauma, or gunshots 

How is sepsis diagnosed?  Patients with sepsis often complain of fever and hard chills, confusion, change in urine (e.g. painful urination, dark and/or cloudy urine), and/or difficulty breathing.  These symptoms are non-specific and could have many causes.  Because of this, both patients and physicians have difficulty recognizing sepsis early when it is easiest to treat.  Physicians look for an obvious site of infection like urinary tract infection or pneumonia.  Once evidence of infection is found, the presence of sepsis can be confirmed by finding bacterial growth in a sample of the patient’s blood.  However, this test can be negative in patients already taking antibiotics. 

How is sepsis treated?  The most important step in the treatment of sepsis is recognizing it early when it is most treatable.  Once sepsis is recognized patients are given lots of fluids to maintain blood pressure and given powerful antibiotics that kill the most common types of bacteria.  The sickest patients are usually admitted to the ICU for close monitoring. Over the next several days the doctor will try to identify the exact bacteria causing the infection and if caused by infection, use an antibiotic that specifically targets that type of bacteria.  If the patient develops organ failure, the doctor may place the patient on a ventilator or provide kidney dialysis.  Over time, the combination of antibiotics, supportive treatment, and the patient’s immune system will hopefully be strong enough to fight off the infection. Sepsis is a medical emergency as declared by the Global Sepsis Alliance and antibiotics and fluids should be administered within one hour.

Because sepsis so common and because it often leads to death, patients and their family members will often be approached to participate in research studies to develop better treatments and protocols.

Source: Lynn B. Gerald, PhD, MSPH, Chair, ATS Assembly on Behavioral Science and Carl Flatley, DDS, Founder, Sepsis Alliance

Four Facts About Sepsis

1. Sepsis is the # 3 cause of death in the U.S. every year and severe sepsis strikes about 750,000 Americans. It has been estimated that between 28 and 50 percent of these people die—far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined.

2. The number of sepsis cases per year has been on the rise in the United States. This may be due to an aging population, the increased longevity of people with chronic diseases, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents.

3. Septic shock occurs when sepsis is complicated by low blood pressure that does not respond to standard treatment (fluid administration) and leads to problems in one or more of the vital organs as described above. The condition means that the body does not receive enough oxygen to properly function and drugs called vasopressors are used to raise the blood pressure. Septic shock patients are very ill and need rapid emergency admission to the hospital intensive care unit ("ICU"). Despite active treatment in the ICU, the death rate is around 50%.

4. Hospitalizations for sepsis, or blood poisoning, more than doubled in the last decade.