Blood poisoning • Recognize and treat symptoms

In the case of blood poisoning, bacteria multiply unchecked and spread through the body via the bloodstream. If treatment is not given in time, sepsis can become life-threatening. The problem: it initially only causes unspecific symptoms. Read here what signs there are, how you can recognize blood poisoning and how it is treated.

Blood poisoning with a high fever as a symptom develops from an existing infection with bacteria or viruses.
© iStock.com/eldinhoid

Blood poisoning (sepsis) often occurs after an operation or a serious bacterial illness such as pneumonia. In these cases, the immune system is weakened and pathogens from an existing infection can multiply in an uncontrolled manner. The bacteria then attack vital organs via the bloodstream. The immune system reacts with strong inflammatory reactions. Both processes are life threatening for the human body.

Current figures show how dangerous blood poisoning is: around 280,000 people in Germany fall ill every year, around 65,000 die from it. Sepsis is the third leading cause of death – after cardiovascular diseases and cancer. The disease is responsible for most deaths in hospital intensive care units.

At a glance:

Blood count: important values ​​and what they mean

Blood count: important values ​​and what they mean

Bacteria are a common cause of blood poisoning

Sepsis develops from an existing infection. Usually bacteria are the cause, less often fungi, viruses or parasites. Blood poisoning often arises from pneumonia, a dragged-out urinary tract infection or a purulent tooth. An infected skin wound can also be the cause.

Usually the immune system ensures that infections remain localized and do not spread. However, some people’s defenses are weakened, for example due to illness, old age, an operation or the use of medication. Particularly aggressive pathogens can also overcome the body’s local defense mechanisms and quickly spread through the body via the bloodstream or the lymphatic system. The germs then attack other organs and there is a risk of organ failure.

SIRS: excessive immune response of the body

The body’s own immune system reacts violently to the multiplication of pathogens and tries to fight them: The organism releases massive amounts of immune and scavenger cells, messenger substances and substances that kill bacteria. However, in their abundance they also damage the blood vessels. The blood clotting gets out of control and blood clots (thrombi) block smaller blood vessels. Doctors refer to the general inflammatory response that affects the whole body as Systemic Inflammatory Response Syndrome (SIRS).

Blood poisoning is therefore not only dangerous because of the pathogens that spread and release toxic metabolic products. The excessive defense reaction of the body also causes serious complications. Failure to get the SIRS under control quickly can result in organ failure, septic shock and ultimately death threatening consequences.

Symptoms: what are signs of blood poisoning?

The problem is the unspecific symptoms of blood poisoning, which many people do not see as dangerous symptoms. Especially since other illnesses like the flu can cause similar symptoms.

Signs of sepsis can include:

  • strong feeling of illness
  • physical weakness, fatigue
  • Fever and chills or a drop in body temperature
  • Palpitations and pulse acceleration to over 100 beats per minute
  • falling blood pressure
  • heavy, rapid breathing
  • sudden confusion, lethargy
  • decreased urine output
  • Pallor, pale gray skin color

If such symptoms occur, those affected should immediately call 911 or go to the emergency room of the nearest hospital. It is generally advisable to go to a clinic if the state of health deteriorates extremely within a few hours during a febrile infection.

Fast diagnosis saves lives

The first step in diagnosing sepsis in the hospital is a blood test. In the blood, for example, there are increased levels of white blood cells (leukocytes) and the hormone precursor procalcitonin (PCT). In addition, the blood values ​​tell whether the function of individual organs is already impaired. In half of the cases, bacteria or other pathogens can be detected in the blood. Blood cultures are created to determine the exact trigger. The results are usually available after one to two days.

Three criteria of diagnosis

The German Sepsis Society has put together some criteria for diagnosis:

  1. Evidence of infection through a microbiological examination or based on typical symptoms of an infection.

  2. Presence of the inflammatory reaction SIRS. This can be determined from your body temperature, heart rate and the number of leukocytes in the blood.

  3. Evidence of organ failure, such as the kidney.

Based on these diagnostic criteria, doctors rate the severity of the disease:

  • If criteria one and two are met, there is blood poisoning.

  • If all three criteria are met, the case is severe.

  • If, in addition to criteria one to three, there is a drop in blood pressure that has existed for at least an hour, doctors assume septic shock.

Imaging tests localize the inflammation

Doctors also try to localize the focus of inflammation from which the sepsis originates. This could be a wound, a urinary tract infection or pneumonia, for example. To do this, they use imaging techniques such as computed tomography or an ultrasound examination. The diagnosis must be made as soon as possible in order to begin effective treatment and save the person’s life.

Treatment: Sepsis is an emergency

After the diagnosis, it is important to eliminate the original source of infection. The focus of inflammation is usually treated as part of an operation. For example, an infected wound is reopened and dead tissue is removed. Another possible treatment is medication to kill the pathogen.

Antibiotics against bacteria

Bacteria usually cause sepsis and antibiotics work against them. First of all, those affected are given a broad spectrum antibiotic that works against various strains of bacteria. At the beginning of treatment, the exact pathogen is usually not yet identified. The antibiotics are usually administered in high doses via an infusion.

If the pathogen causing blood poisoning is found on the basis of the blood culture, a switch is made to an antibiotic that works specifically against the triggering bacteria. If the pathogen remains unknown, therapy with the broad spectrum antibiotic is continued.

Intensive care medicine for the severe course

Severe sepsis is treated in intensive care. It occurs when vital organs begin to fail, such as the heart, liver or kidney. Sufferers receive infusions with electrolyte or saline solution to compensate for the loss of fluid and to stabilize the circulation. Because the general inflammatory reaction SIRS and the infection itself make the blood vessels permeable, fluid passes into the tissue. The result is a drop in blood pressure, which can be counteracted by adding fluids.

The choice of infusion solution seems to be decisive for the success of the therapy. Studies have shown that the frequently used infusion treatment with hydroxyethyl starch (HES) doubles the risk of kidney failure and – depending on the dosage – increases mortality. Therefore, the supply of fluids and electrolytes with lactated Ringer’s is recommended today.

Preserve organ function

It is important to stabilize the function of the affected organs. For example, dialysis may be necessary in the event of a kidney malfunction or artificial respiration if there is a threat of organ failure in the lungs. Medicines put those affected into an artificial coma. A tube feeds them artificially and supplies them with vital nutrients.

In septic shock, blood pressure drops sharply. Organs are no longer adequately supplied with blood, oxygen and nutrients. The sick are given drugs to increase blood pressure (vasopressor substances). This includes, for example, norepinephrine, which causes blood pressure to rise particularly sharply.

Course: how dangerous is sepsis?

The course depends crucially on how quickly the blood poisoning is recognized and treated. If the blood poisoning is uncomplicated, the chances of recovery are good. Severe sepsis, on the other hand, is fatal in almost half of the cases. Even in the case of septic shock, the chances of survival are slim.

Anyone who has survived severe sepsis or septic shock needs a long recovery period. Because both the body and the psyche burden the serious illness considerably. It often has health consequences. Examples are:

Can you prevent blood poisoning?

Sepsis always arises from an existing infection. Those who protect themselves against infections also principally prevent blood poisoning. The following tips will help prevent this:

  • Adequate hygiene: It is best for medical staff and clinic visitors to wash their hands thoroughly and disinfect them before and after each contact with patients.

  • Pay attention to the vaccination protection: It is best to get vaccinated against common pathogens of bacterial infectious diseases, for example pneumococci, meningococci and haemophilus.

  • Take antibiotics sparingly: Today, many bacteria are insensitive (resistant) to common antibiotics. You should only take these drugs when necessary and strictly follow your doctor’s instructions to prevent resistance.

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