Septicemia

Septicemia is a bloodstream Infection. It is also known as blood poisoning. Septicemia occurs when a bacterial infection elsewhere in the body, such as the lungs or skin, enters the bloodstream. This is dangerous because the bacteria and toxins can be carried through the bloodstream to your entire body. Septicemia can quickly become life-threatening. It must be treated in a hospital. If left untreated, septicemia can progress to sepsis. 

Septicemia and sepsis aren’t the same. Sepsis is a severe complication of septicemia. Sepsis causes inflammation throughout the body. This inflammation can cause blood clots and block oxygen from reaching vital organs, resulting in organ failure. When the inflammation occurs with external blood pressure, it is called septic shock.

 Types

• Primary Septicaemia
• Secondary septicemia

Primary Septicaemia: is caused by an infection in another part of your body. This infection is typically severe. Many types of bacteria can lead to septicemia. The exact source of the disease often cannot be determined.

Secondary Septicemia: The most common infections that lead to septicemia are:

• Urinary Tract Infections ( E.coli)
• Lung Infections, such as pneumonia ( Streptococcus pneumonia)
• Kidney Infections
• Infections in the abdominal and pelvic area (N.gonorrhoeae)
• Skin (Cetaphil aureus)
• Gall bladder (e.coli,streptococcus faecalis)

These infections enter the bloodstream and multiply rapidly, causing immediate symptoms.

Hospital-Acquired Infection

People already in the hospital for something else, such as surgery, are at a higher risk of developing septicemia. Secondary infections can occur while in the hospital. These infections are often more dangerous because the bacteria may already be resistant to antibiotics. You may have a high risk of developing septicemia in hospital if you:

• Have severe wound injury or burns.
• Are very young or very old.
• Have a compromised immune system, which can occur from conditions like HIV or leukemia or medical treatments such as chemotherapy or steroid injections.
• Have a urinary or intravenous catheter.
• Are on mechanical ventilation.

The symptoms of septicemia start very quickly. Even in the first stages, a person can look very sick. They may follow an injury, surgery, or another localized infection, such as pneumonia. The most common initial symptoms are:

• Chills
• Fever
• Breathing very fast (tachycardia)
• Rapid heart rate (tachypnoea)
• Rash (suggestive of meningococcus)
• Cool Extremities

Severe symptoms may begin to emerge as septicemia progresses without proper treatment. These include the following:

• Confusion or inability to think clearly
• Nausea and Vomiting
• Red spots that appear on the skin
• Reduced Urine Volume
• Inadequate Blood Flow
• Shock

• Evaluation of patient’s symptoms and taking a medical history. 
• Physical examination to look for low blood pressure or body temperature.
• Laboratory diagnostic tests are as follows:
• Urine culture
• Wound Secretions and sore skin cultures
• Respiratory Secretions(sputum culture)
• Complete Blood Count
• Coagulation Profile
• Blood Cultures
• Arterial Blood gases to know the levels of oxygen and carbon dioxide.
• Other signs to look for conditions that more commonly occur along with septicemias, such as pneumonia, meningitis, and cellulitis. 

Your healthcare provider may require certain specific radiology tests to look more closely at specific organs and tissue, such as:

• X-ray
• MRI
• CT scan
• Ultrasound

Septicemia that has started to affect your organs or tissue function is a medical emergency. Treatment will depend on several factors, including:

• Your age
• Your Overall Health
• The Extent of your condition
• Your Tolerance to specific medications

Antibiotics are used to treat bacterial infections causing septicemia. Initial treatment will usually use “broad-spectrum” antibiotics.

·         Empirical initial treatment after blood cultures, e.g., flucloxacillin 2g IV with gentamicin 4-6mg\kg IV

·         A focused antibiotic may be used if the specific bacteria is identified by blood culture.

·         I\V fluids and other medications intravenously to maintain blood pressure. Anticoagulants to prevent blood clots from forming.

·         Oxygen inhalation if any breathing issues.

Septicaemia has several serious complications. These complications may be fatal if left untreated or if treatment is delayed for too long.

• Sepsis: Sepsis occurs when your body has a robust immune response to the infection. This leads to widespread inflammation throughout the body. It’s called severe sepsis if it leads to organ failure. People with chronic diseases are at a higher risk of sepsis. This is because they have a weakened immune system and can’t fight off the infection independently.
• Septic Shock: One complication of septicemia is a drop in blood pressure. This is called septic shock. Toxins released by the bacteria in the bloodstream can cause shallow blood flow, resulting in organ or tissue damage. Septic shock is a medical emergency. People with septic shock are usually cared for in a hospital’s intensive care unit. You may need to be put on a ventilator or breathing machine if you are in septic shock.
• Acute Respiratory Distress Syndrome (ARDS): Another complication of septicemia is acute respiratory distress syndrome (ARDS). This life-threatening condition prevents enough oxygen from reaching your lungs and blood. It often results in some level of permanent lung damage. It can also damage your brain, leading to memory problems.

Outlook

On early diagnosis, septicemia can be treated effectively with antibiotics. Even with treatment, it is possible to have permanent organ damage for people with preexisting conditions that affect their immune systems.

• Avoid smoking
• Avoid illegal drugs
• Eat a healthy diet
• Exercise regularly 
• Wash your hands regularly
• Stay away from people who are sick
• Boost immune system
• Early diagnosis and treatment of infection anywhere in the body