What are the other Names for this Condition? (Also known as/Synonyms)

• Bacteremia with Sepsis
• Blood Poisoning (Sepsis)
• Septic Shock

What is Septicemia? (Definition/Background Information)

• Septicemia is a serious, life-threatening infection of blood resulting from a microbial (bacteria or fungi) infection in the body. An infection in one part of the body (such as the lungs, urinary tract, or abdomen) can spread to the bloodstream. The circulating pathogens and their toxins, can then quickly spread to other parts of the body
• Injuries sustained during accidents and infected wounds (such as third-degree burns) can also lead to the spread of pathogens and toxins into the bloodstream. Elderly individuals, those with weak or immature immune systems, and with certain diseases are more at risk for developing Septicemia
• Bacteria belonging to Staphylococcus, Streptococcus, and Enterococcus species, are the most common causative agents of the condition. Candida spp. are the most common fungi that cause the condition.
• The signs and symptoms of Septicemia are varied, and can include sudden onset of fever, rapid breathing, accelerated heart rate, anxiety, and general weakness. The condition can result in several complications including respiratory failure, heart failure, and multiple organ failure, which can be fatal in some individuals
• A healthcare provider may order blood and/or urine culture studies, and conduct other tests to diagnose Septicemia. Once the causative organism is identified, the affected individual is given antibiotics and treated at a medical facility. If necessary, a surgery may be performed to drain fluid from the affected organs. Additionally, feeding and breathing aids may become necessary, in some patients
• Vaccinating children against Haemophilus influenza and Streptococcus pneumoniae is reported to help reduce the occurrence of Septicemia in children. Keeping oneself clean, washing hands frequently, proper wound care, and seeking prompt medical care for infections, are some preventive methods for Septicemia
• The prognosis is dictated by the type of pathogen involved, promptness in seeking medical attention, and response to treatment of the affected individual. In many cases, with immediate treatment, the prognosis is improved

Who gets Septicemia? (Age and Sex Distribution)

• Septicemia can affect individuals of all ages, both genders, and belonging to all races and ethnicities
• However, elderly adults, individuals who are immunocompromised, or on immunosuppressant medications, and newborns with poorly-developed immune systems are particularly vulnerable to the condition

What are the Risk Factors for Septicemia? (Predisposing Factors)

The following are some known risk factors for Septicemia:

• A suppressed or weakened immune system (such as individuals with HIV infection or AIDS)
• An immature immune system, especially observed in newborns and young babies
• Individuals with genetic predisposition causing weakened immune system
• Being on immunosuppressive drugs
• Advanced age (over 60 years of age) with chronic medical conditions
• Leukemia, or other types of cancer
• Recent hospitalization, recent surgery
• Poorly-controlled diabetes
• Abusing drugs
• Long-term catheter use
• Having undergone a complicated labor or delivery
• Certain surgical procedures can increase the risk for Septicemia
• Having third-degree burns

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Septicemia? (Etiology)

Septicemia is a condition wherein certain pathogens and their toxins spread into the bloodstream. The causative organisms of the condition can either be bacteria or fungi:

• Some bacteria that can cause Septicemia include Staphylococcus aureus, Streptococcus spp., and Enterococcus spp. (all of which are gram-negative bacteria)
• In neonates, certain other bacteria, namely Escherichia coli, Eikenella corrodens and Haemophilus influenza, are the more common causative pathogens
• Among fungi, the most common pathogens causing Septicemia include several species of Candida

Modes of infection:

• The bacteria or fungi can infect the skin (through cuts), lungs, mouth, and gastrointestinal tract. It can also cause infection through surgical site wounds and intravenous catheter points. The infection can then spread directly or indirectly to the bloodstream
• Third-degree burns can also result in infections, with eventual spread of the infection to the bloodstream
• Internal injuries in the abdomen, such as those caused by an accident, intestinal rupture, gallbladder disease, and rupture of the appendix and spleen, can also lead to the spread of pathogens and their toxins to the bloodstream

What are the Signs and Symptoms of Septicemia?

The signs and symptoms of Septicemia include:

• Sudden onset of high fever or low temperature, chills, profuse sweating
• Elevated heart rate (tachycardia)
• Rapid breathing, shortness of breath
• Low or high white blood cell count
• Nausea, vomiting, and diarrhea
• Confusion, anxiety
• Weakness, lethargy, general malaise, and drowsiness
• Dusky skin appearance
• Reduced urine output
• Decreased mental acuity
• Headaches
• Pain
• Unexplained rashes; red lines or streaks on skin

The following symptoms in an expectant mother may rise concerns that the neonate may have Septicemia:

• Fever during delivery
• Cloudy or smelly amniotic fluid

The symptoms of Septicemia in neonates may include:

• Abnormal vital signs
• Projectile vomiting
• Seizures

How is Septicemia Diagnosed?

In order to diagnose Septicemia accurately, a healthcare provider may employ the following methods:

• A thorough physical examination and an assessment of symptoms, with emphasis on body temperature and blood pressure
• Tests to check for pneumonia, epiglottitis, cellulitis and meningitis; conditions that are reported to coexist with Septicemia
• Blood tests to assess the following:
  • Complete blood counts: Check counts of various blood cell types
  • Culture for pathogens
  • Check for the presence of bacteria or fungi using techniques, such as counter-immunoelectrophoresis, litmus test, and gas chromatography
  • Perform clotting studies
• Apart from blood, other body fluids such as urine, sputum, phlegm, cerebrospinal fluid, and secretions from wounds, are used to check for the presence of pathogens through culture and/or immunological testing
• Culture of infected tissue, to check/confirm initial site of infection
• Culture of skin sores, to check for the presence of pathogens
• Novel methods to detect the presence of virulent pathogens in blood or other body fluids, at an early stage, so treatment can begin without delay
• Techniques, such as magnetic resonance imaging (MRI), X-rays, ultrasound and computerized tomography (CT) scans may be required to assess the organ structure and pathology
• Functional analysis of organs, such as liver and kidneys, to assess compromised function, if any
• Check the arterial gases to monitor metabolic acidosis
• Electrocardiography to check for abnormalities in heart function, if any

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Septicemia?

The complications associated with Septicemia include:

• Acute respiratory distress syndrome (ARDS) causing breathing difficulties, which in turn leads to respiratory failure
• Compromised heart function resulting in heart failure
• Kidney failure
• Disseminated intravascular coagulation (DIC), causing blood to clot in the blood vessels, leading to hemorrhage
• Muscle weakness caused by polyneuropathy
• Endocarditis, causing inflammation of the lining of the heart chambers and heart valves
• Acute nephritis; swelling and inflammation of the glomeruli in the kidney
• Abscess formation
• Multiple organ failure including failure of the heart, liver, lungs and kidneys; this often results in fatalities
• Reduced blood circulation leading to gangrene formation
• Stroke
• Septic shock: If low blood pressure levels does not improve with the administration of intravenous fluids, the patient suffers from a septic shock, which can often be fatal

How is Septicemia Treated?

A treatment of Septicemia is undertaken in a hospital setting and may include the following measures:

• Antibiotics that are administered intravenously: Initially, antibiotics that are effective against most bacteria are given. Following this, when the blood culture report is received and the exact bacteria that caused the infection identified, a specific antibiotic to fight the pathogen is administered
• Surgical removal or drainage of infected tissue: Any abscess that is the source for infection is drained and infected tissues are surgically removed
• Intravenous (IV) fluids are used to maintain normal blood pressure levels. Medications, such as dopamine, are used in some patients in addition to the fluids
• Ventilator support: This is used to maintain the oxygen level in the patient, to improve the respiratory function
• Maintenance of glucose and nutrition levels
• Depending on the severity of the infection, other methods, such as breathing machines and dialysis, may be necessary
• Vasopressors (drugs that dilate the blood vessels) may be used to improve blood pressure

How can Septicemia be Prevented?

The following preventive measures for Septicemia may be considered:

• Getting children vaccinated: Vaccines against Haemophilus influenza B (HIB) and S. pneumoniae have reduced the level of infection in children
• Seeking prophylactic treatment: Individuals (such as family members), in close contact with an infected individual, can be prescribed preventive antibiotics
• Seeking prompt medical attention for infections
• Keeping wounds and burns clean and with proper dressing
• Having regular dental check-ups to prevent infection of the mouth and teeth
• Frequently washing hands
• Using sterile gloves and masks while handling infected individuals or tissue

What is the Prognosis of Septicemia? (Outcomes/Resolutions)

• The prognosis of Septicemia depends on the type of pathogen (bacteria or fungus) involved and whether the treatment and hospitalization are undertaken in a prompt manner. The fatality rate for Septicemia is reported to be high, if treatment is delayed
• The prognosis also depends on the following:
  • Overall health of the individual
  • The individual’s response to treatment
  • The underlying cause of Septicemia
• If Septicemia is caused by drug-resistant bacteria or fungus, then the prognosis is guarded

Additional and Relevant Useful Information for Septicemia:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/blood-disorders/