Sepsis infection: An introduction
Sepsis infection is a common term used by patients to describe what we call infection with sepsis in the medical community. Sepsis infection can be caused by any infection. When an infection spreads and become overwhelming, it may spread into the bloodstream. As the bacteria gets into the blood, many different kinds of toxins are released and they cause a numer of changes in body. These changes are summarized as sepsis infection.Kidney infection is a common cause of infection with sepsis.
Sepsis infection: An 85 year old female from nursing home
Mrs. G is a normally cheerful 85 year old female who has a touch of dementia. She is not very mobile because of her back but she does use a walker and is able to go from bed to the bathroom by herself. She does remember the names of all her grandchildren who visit her regularly on the weekend. But, she usually forgets what she had her for lunch when it is time for dinner.
One morning, the nurse went into her room to check on her but she seemed very sleepy. It was somewhat unusual as she normally woke up very early and greeted the nurse very warmly in the morning. The went back after an hour and she was still sleepy. This time the nurse was worried and tried to shake her up. She opened her eyes briefly but went back to sleep again. She then checked her blood pressure and it was low. She immediately triggered the emergency response system. Paramedics were called and she was rushed to ER. In the ER, she had an iv line placed and was flushed with three liters of iv fluids before her blood pressure improved. She was very lethargic and was unable to answer any questions.
As the on-call doctor, I admitted Mrs. N to ICU and continued with iv fluids. As I reviewed her blood work, it seemed like patient was having sepsis infection. To be accurate, she was having a particular type of septic infection called septic shock. Septic shock is the kind of sepsis infection that can cause the patient’s blood pressure go down. In patients with sepsis infection with septic shock, the body is overwhelmed with unfection and is in a state of shock. These patients with sepsis infection and shock can quickly develop multiple organ system failure and can die within a few hours if not treated quickly and appropriately. Antibiotics need to be started ASAP and blood pressure needs to be corrected as fast as possible.
In some cases with sepsis infection and shock, the source of infection may not be clear initially. In those sepsis infection patients, antibiotics must be selected empirically. In those sepsis infection, you do not know what infection you are treating. That is why you need to use antibiotics that can treat almost all types of infection. When we started treating the sepsis infection in Mrs B, we did not know what we were treating. It only became clear after a few hours.
At first, our patient’s body was so overwhelmed with the sepsis infection that her kidneys were completely shut down. Her kidneys stopped filtering the blood and stopped making any urine because of the shock. Only after correcting her low blood pressure with many liters of iv fluids, we were able to get some urine off of her. We had done several other tests and scans but did not have any luck with a specific diagnosis of her sepsis infection.We got our answer after we had the urine test back from the lab. Her urine almost resembled pus. It had so many white blood cells in it that it appeared almost cloudy white. That is an indication of overwhelming kidney infection. Our patient was so overwhelmed with sepsis infection that she did not have any time to develop the usual symptoms of kidney infection and went right to sepsis infection and shock.
She did improve with the treatment. Her blood pressure continued to go up and became stable by the third day in the hospital. She started to wake up more and stated to make sense of things around her. Finally she was awake and clear enough to recognize her grand children. She was them moved out of the ICU. She stayed in the medical floor for 3 more days and was finally discharged back to nursing home.
This is how many elderly patients in nursing homes present with sepsis infection from a urine infection.I hope the story of Mrs N helped you understand more about sepsis infection. Please check back soon as I will be uploading more stories about different aspects of patients with sepsis infection.