| Subject | Contents |
| Definition | Septicemia is the presence of bacteria in the blood ( bacteremia ) and is often associated with severe disease. |
| Alternative Names | Blood poisoning; Bacteremia with sepsis |
| Causes, incidence, and risk factors | Septicemia is a serious, rapidly progressive, life-threatening infection that can arise from infections throughout the body, including infections in the lungs, abdomen, and urinary tract. It may precede or coincide with infections of the bone ( osteomyelitis ), central nervous system ( meningitis ), or other tissues. Septicemia can rapidly lead to shock '>septic shock and death. Septicemia associated with some organisms such as meningococci can lead to shock , adrenal collapse and disseminated intravascular coagulopathy , a condition called Waterhouse-Friderichsen syndrome . Onset of septicemia can be heralded by spiking fevers and chills, rapid breathing and heart rate, the outward appearance of being seriously ill (toxic) and a feeling of impending doom. These symptoms rapidly progress to shock with decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in the mental status, and clotting abnormalities evidenced by hemorrhagic lesions in the skin (petechiae and ecchymosis). |
| Symptoms | fever (sudden onset, often spiking) chills toxic looking (looks acutely ill) changes in mental state irritable lethargic anxious agitated unresponsive comatoseshock cold clammy pale cyanotic (blue) unresponsive skin signs associated with clotting abnormalities petechiae ecchymosis (often large, flat, purplish lesions that do not blanch when pressed) gangrene (early changes in the extremities suggesting decreased or absent blood flow) decreased or no urine output |
| Signs and tests | Physical examination may show: low blood pressure ( hypotension )low body temperature ( hypothermia ) or fever signs of associated disease ( meningitis , epiglottitis , pneumonia , cellulitis , or others) Tests that can confirm infection include:blood cultureurine cultureCSF culture culture of any suspect cutaneous lesion CBCplatelet count clotting studies PTPTTfibrinogen levels blood gas |
| Treatment | This disorder must be treated in a hospital, usually with admission to an intensive care unit. Intravenous (IV) fluids are given to maintain the blood pressure . Strong IV drugs called sympathomimetics are often needed to maintain the blood pressure. Oxygen therapy is begun to maintain oxygen saturation. The infection is treated with broad spectrum antibiotics (those that are effective against a wide range of organisms) before the organism is identified. Once cultures have identified the specific organism that is responsible for the infection, antibiotics that are specific for that organism are begun. Plasma or other treatment may be needed for correction of clotting abnormalities. |
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| Expectations (prognosis) | Septic shock has a high death rate, exceeding 50%, depending on the type of organism involved. The organism involved and the immediacy of hospitalization will determine the outcome. |
| Complications | irreversible shockWaterhouse-Friderichsen syndromeadult respiratory distress syndrome ( ARDS ) |
| Calling your health care provider | Septicemia is not common but is devastating and early recognition may prevent progression to shock . Any child with fever , shaking chills, and who looks acutely ill should be seen immediately as an emergency. Any child with evidence of bleeding into his skin should be seen immediately as an emergency. Any child who has been ill and has any changes in mental status should be seen immediately as an emergency. Call your health care provider if your child is not current on vaccinations or has not had immunizations for Hemophilus influenza B , commonly referred to as a HIB shot. If your child has a damaged spleen from any disease process or has had it removed, schedule an appointment for an immunization against pneumococcal disease. |
| Prevention | Appropriate treatment of localized infections can prevent septicemia. HIB vaccine for children has already reduced the incidence of Hemophilus septicemia (and Hemophilus meningitis , epiglottitis , and periorbital cellulitis ) and is a routine part of the recommended childhood immunization schedule. Children who have had their spleen removed or who have diseases that damage the spleen (such as sickle cell anemia ) should receive pneumococcal vaccine. Pneumococcal vaccine is not part of the routine childhood immunization schedule. Close contacts (parents, siblings, friends) of septic children with certain organisms such as pneumococcus, meningococcus, and Hemophilus may require preventive antibiotic therapy. This will be prescribed by the health care provider and the type of antibiotic will be determined by the organism involved. |
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