What is Sepsis?
Sepsis, the systemic response of the organism to an uncontrolled infection, is commonly caused by invading bacteria, and increasingly by fungi as well. It is a life-threatening condition that arises when the body’s response to an infection damages its own tissues and organs. Sepsis can lead to shock, multiple organ failure, and death, especially if it is not recognized early and treated promptly. Sepsis is the leading cause of death from infection around the world.
In Germany, 154,000 new cases of sepsis occur every year, killing an average of 150 patients each day. Sepsis is thus more common than stroke, breast cancer, or colon cancer. Despite advances in modern medicine, like vaccines, antibiotics, and acute care, the incidence of sepsis is increasing every year as the population ages and more invasive medical procedures are performed. Therefore, sepsis must be regarded as a major barrier to medical progress and a hidden healthcare disaster.
Sepsis can occur as a complication of any infection, such as pneumonia, tonsillitis, urinary tract infections, inflammation of the abdomen (peritonitis), or following trauma or surgical procedures. Thus, sepsis is common in nearly every medical discipline. The inflammatory response of the entire body, coupled with organ failure, makes sepsis a highly complex and dynamic disease. The unspecific symptoms of sepsis are often delayed, also due to inadequate diagnostic tools, and under-recognized in clinical documentation.
The dynamic stages of sepsis
- A local infection overcomes the body’s local defense mechanisms, and pathogenic microorganisms and the toxins they produce invade the circulatory system from the original site of infection, triggering a general inflammatory response. The blood vessels around the infection focus expand and become more permeable. The release of messenger substances (mediators of inflammation) allows white blood cells to penetrate the vascular walls into the tissues to fight the pathogens. The blood in the micro-vessels surrounding the infection coagulates as a defence mechanism.
- This inflammatory response leads to collateral damage: circulating mediators affect the function of individual organs, which start to deteriorate and then completely fail.
- Several organs stop functioning, either sequentially or simultaneously. In severe cases, blood pressure drops dramatically, the heart races, the oxygen supply to the blood via the lungs deteriorates, the oxygen supply to the organs and tissues is choked, the kidneys stop producing urine, and the patient’s mental status is gravely impaired. The patient’s life is in acute danger. Doctors call this septic shock.