Sepsis, also known colloquially as blood poisoning, is an acute life-threatening reaction of the body to an infection. An excessive immune response can cause it to worsen rapidly and lead to organ failure, septic shock or even death. Early detection and treatment with antibiotics are key to increasing the chances of survival in cases of blood poisoning.

Sepsis at a glance

When pathogens such as bacteria, viruses or fungi enter the body, the immune system normally creates a localised inflammatory response. Sepsis occurs when infection passes through the local immune barriers and pathogens spread into the bloodstream. triggering an inflammatory response throughout the body that can no longer be controlled.

In such a state, the misdirected immune response damages not only the pathogens, but also the body’s own tissues; the body essentially attacks its own organs, which can lead to organ failure, septic shock or even death. Sepsis is therefore referred to as a life-threatening organ dysfunction caused by a dysregulated host response.

Septic shock

Septic shock, the most severe form of sepsis, occurs when blood pressure remains very low despite the administration of fluid and when elevated lactate levels are measured in the blood at the same time. This indicates that there is no longer an adequate supply of blood to the tissues. Septic shock is an acute emergency and requires immediate intensive care.

Causes of sepsis

Risk factors for sepsis

In principle, anyone can develop sepsis. However, certain groups are at increased risk of developing a serious infection that turns into blood poisoning. These include in particular:

  • Adults aged 65 and over
  • Babies and young children
  • Patients with a weakened immune system, e.g. due to chemotherapy, HIV/AIDS or autoimmune diseases
  • People with chronic illnesses such as diabetes, kidney dysfunction or heart failure
  • Patients who have undergone major surgery or have large wounds that carry an increased risk of infection
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Symptom of sepsis

The earlier sepsis is detected and treated, the greater the chances of survival. In the early stages, however, the symptoms of blood poisoning are often non-specific and can easily be confused with the symptoms of a cold or flu.

Blood poisoning often manifests itself through a combination of different symptoms. The main symptoms include:

  • Beschleunigte Atmung
  • Niedriger Blutdruck
  • Verwirrtheit, Orientierungslosigkeit oder ausgeprägte SchläfrigkeitGeschlechterspezifische Symptome einer Lungenembolie

In addition, the following symptoms may occur:

  • Fever or chills
  • Increased heart rate (tachycardia)
  • Cold hands and feet
  • Pale or mottled skin
  • Joint or muscle pain
  • Decreased urination (oliguria)

If these symptoms occur in connection with an infection, it should be assumed that sepsis is present. In this case, it is important to go to hospital immediately or call the emergency services.

Diagnosing blood poisoning

Since sepsis is an acute life-threatening condition, it is imperative that it is diagnosed immediately and without delay. In emergency situations, doctors first refer to scores such as the qSOFA score (quick Sepsis-Related Organ Failure Assessment), to quickly assess whether there is an increased risk of severe blood poisoning. Only then is the more comprehensive SOFA score used to assess which organs are already affected.

qSOFA score: rapid initial diagnosis of sepsis

The qSOFA score comprises three easy-to-assess criteria:

  • Altered consciousness (e.g. confusion or decreased alertness)
  • Low blood pressure
  • Rapid breathing

If two or more of these criteria are met, the probability of severe sepsis is considered to be increased. In this case, immediate emergency medical measures are usually taken to control the infection, stabilise blood circulation and prevent organ damage.

SOFA score: assessment of organ function

This is followed by a detailed assessment of which organs are already damaged. Six different systems are examined for this purpose:

  • Respiratory system: ratio of PaO₂ to FiO₂ (gas exchange in the lungs)
  • Central nervous system: Glasgow Coma Scale (level of consciousness)
  • Cardiovascular system: mean arterial blood pressure (MAP) and/or the need for vasopressors (medications to increase blood pressure)
  • Hepatic system: bilirubin levels in the blood
  • Blood coagulation: number of thrombocytes (blood platelets)
  • Renal system: creatinine

Each affected organ system is rated on a scale from 1 (slightly affected) to 4 (severely affected). The sum of all values gives the total SOFA score, which indicates how far the sepsis has progressed and how high the risk of organ failure is.

Treatment of sepsis 

Treatment for blood poisoning usually begins in the emergency room. Depending on the severity of the sepsis, different treatment measures are used:

  • (Broad-spectrum) antibiotics
    A broad-spectrum antibiotic is usually given to start with, as this is effective at killing many different strains of bacteria and is thus able to quickly fight the most likely pathogens. As soon as further findings are available, the treatment can be adapted to the specific pathogen that has been identified.
  • Intravenous fluid administration
    To stabilise blood circulation, patients receive intravenous infusions that increase blood volume (volume therapy) and thus improve blood flow to the organs. This is a key part of early treatment.
  • Vasopressors
    If infusions alone are unable to increase blood pressure sufficiently, medications to support blood circulation are used. These cause the blood vessels to constrict, thereby helping to maintain blood pressure and blood flow to vital organs.
  • Respiratory support
    Additional oxygen may be necessary in cases of impaired lung function. In severe cases, mechanical ventilation is required to supply the body with sufficient oxygen.
  • Removal of the source of infection
    If sepsis is caused by a clearly identifiable source of infection, such as an abscess, inflamed tissue or a foreign body, surgical removal of the source of infection may be necessary.
  • Support for damaged organs
    If organs fail as a result of sepsis, special measures are required, such as dialysis for kidney failure or medication to stabilise cardiovascular function. The aim is to relieve strain on the organs until the body recovers.

Prevention

Early treatment of infections and good wound care are key measures for preventing sepsis. Regular hand washing, careful handling of catheters and medical devices, and vaccination against common causes of infection can further reduce the risk of sepsis. People with chronic illnesses or a weakened immune system should take signs of infection particularly seriously.

FAQ on sepsis

Can any infection cause sepsis?

Although it is rare, almost any infection can develop into sepsis, regardless of whether it was caused by bacteria, viruses or fungi. Untreated, severe or rapidly spreading infections, such as those of the lungs, urinary tract, abdominal cavity or larger wounds, are particularly dangerous.

Is sepsis contagious?

Sepsis itself is not contagious; it is the body’s response to an infection. However, the underlying infection, such as pneumonia or a gastrointestinal infection, can be quite contagious.

Who is at increased risk of blood poisoning?

Older people, infants, people with a weakened immune system and those with a chronic illness are particularly at increased risk of sepsis. Patients with diabetes, kidney failure or heart failure are also at greater risk. The risk is also higher after major surgery or in the case of extensive wounds.

When is sepsis overcome?

Sepsis is considered to have been overcome as soon as the infection is under control and organ functions have stabilised. However, the path to a full recovery can take weeks or even months. Regular medical check-ups and accompanying therapies support recovery.

Is it possible to fully recover from sepsis?

Many people recover fully from sepsis, especially if it is detected and treated early. Nevertheless, the body can be severely weakened, meaning that recovery can often take weeks or even months. Some people develop post-sepsis syndrome with persistent fatigue, concentration problems or psychological stress.

What is the mortality rate for sepsis?

The chances of survival in cases of sepsis depend on the severity, the general condition of the patient and the timeliness of treatment. Early detection of sepsis offers significantly better chances of survival than severe or late-diagnosed cases. Septic shock is associated with particularly high risks.

How quickly does sepsis develop?

Sepsis can develop within a few hours. In high-risk patients in particular, their condition can deteriorate very quickly.