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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Septic shock

Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Last reviewed: February 8, 2014.

Septic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.

Causes

Septic shock occurs most often in the very old and the very young. It may also occur in people with weakened immune systems.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage. This may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.

The body has a strong inflammatory response to the toxins that may contribute to organ damage.

Risk factors for septic shock include:

  • Diseases of the genitourinary system, biliary system, or intestinal system
  • Diseases that weaken the immune system, such as AIDS
  • Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters and plastic and metal stents used for drainage)
  • Leukemia
  • Long-term use of antibiotics
  • Lymphoma
  • Recent infection
  • Recent surgery or medical procedure
  • Recent use of steroid medications
  • Solid organ or bone marrow transplantation

Symptoms

Septic shock can affect any part of the body, including the heart, brain, kidneys, liver, and intestines. Symptoms may include:

Exams and Tests

Blood tests may be done to check for:

  • Infection around the body
  • Low blood oxygen level
  • Disturbances in the body's acid-base balance
  • Poor organ function or organ failure

Other tests may include:

Additional studies, such as blood cultures, may not become positive for several days after the blood has been taken, or for several days after the shock has developed.

Treatment

Septic shock is a medical emergency. In most cases, people are admitted to the intensive care unit of the hospital.

Treatment may include:

The pressure in the heart and lungs may be checked. This is called hemodynamic monitoring. This can only be done with special equipment and intensive care nursing.

Outlook (Prognosis)

Septic shock has a high death rate. The death rate depends on the patient's age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started.

Possible Complications

Respiratory failure, cardiac failure, or any other organ failure can occur. Gangrene may occur, possibly leading to amputation.

When to Contact a Medical Professional

Go directly to an emergency department if you develop symptoms of septic shock.

Prevention

Prompt treatment of bacterial infections is helpful. However, many cases of septic shock cannot be prevented.

References

  1. Jones AE, Kline JA. Shock. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 6.
  2. Rivers EP. Approach to the patient with shock. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 106.
  3. Munford RS. Severe sepsis and septic shock. In: Fauci AS, Harrison TR, eds. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:chap 265.

Review Date: 2/8/2014.

Reviewed by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • A long course (five days or more) of a low dose of corticosteroids may be considered as an adjunct therapy in patients with septic shock.A long course (five days or more) of a low dose of corticosteroids may be considered as an adjunct therapy in patients with septic shock.
    Septic shock is the most severe form of infection. It may also interfere with the production of corticosteroids, a key hormone for host defence against infection. This review showed that corticosteroids did not impact on mortality overall. However, the trials conducted after the scientific community agreed upon a consensual definition of sepsis, in 1992, suggested that a low dose of corticosteroids for five days or more improved the survival of patients in septic shock without causing harm They did develop some metabolic disorders. Trials performed before 1992 showed no benefit from a short course of high dose corticosteroids.
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