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Septicemia
Definition
Septicemia is bacteria in the blood (bacteremia) that often occurs with severe infections.
Alternative Names
Blood poisoning; Bacteremia with sepsis
Causes
Septicemia is a serious, life-threatening infection that gets worse very quickly. It can arise from infections throughout the body, including infections in the lungs, abdomen, and urinary tract. It may come before or at the same time as infections of the:
- Bone (osteomyelitis)
- Central nervous system (meningitis)
- Heart (endocarditis)
- Other tissues
Symptoms
Septicemia can begin with:
- Chills
- High fever
- Rapid breathing
- Rapid heart rate
The person looks very ill.
The symptoms quickly progress to:
There may be decreased or no urine output.
Exams and Tests
A physical examination may show:
- Low blood pressure
- Low body temperature or fever
- Signs of related disease (such as meningitis, epiglottitis, pneumonia, or cellulitis)
Tests that can confirm infection include:
- Blood culture
- Blood gases
- CBC
- Clotting studies
- PT
- PTT
- Fibrinogen levels
- CSF culture
- Culture of skin sore
- Platelet count
- Urine culture
Treatment
Septicemia is a serious condition that requires a hospital stay. You may be admitted to an intensive care unit (ICU).
You may be given:
- Antibiotics to treat the infection
- Fluids and medicines by IV to maintain the blood pressure
- Oxygen
- Plasma or other blood products to correct any clotting problems
Outlook (Prognosis)
The outlook depends on the bacteria involved and how quickly the patient is hospitalized and treatment begins. The death rate is high -- more than 50% for some infections.
Possible Complications
Septicemia can quickly lead to:
- Adult respiratory distress syndrome (ARDS)
- Septic shock
- Death
Septicemia due to meningococci can lead to shock or adrenal collapse (Waterhouse-Friderichsen syndrome).
When to Contact a Medical Professional
Septicemia is not common but it is very serious. Diagnosing it early may prevent septicemia from worsening to shock.
Seek immediate care if:
- A person has a fever, shaking chills, and looks very ill
- Any person who has been ill has changes in mental status
- There are signs of bleeding into the skin
Call your health care provider if your child's vaccinations are not up-to-date.
Prevention
Getting treated for infections can prevent septicemia. The Haemophilus influenza B (HIB) vaccine and S. pneumoniae vaccine have already reduced the number of septicemia cases in children. Both are recommended childhood immunizations.
In rare cases, people who are in close contact with someone who has septicemia may be prescribed preventive antibiotics.
References
Munford RS, Suffredini AF. Sepsis, severe sepsis, and septic shock. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2009: chap 70.
Shapiro NI, Zimmer GD, Barkin AZ. Sepsis syndromes. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 136.
Orenstein WA, Pickering LK. Immunization practices. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011: chap 165.
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
