Septicemia is bacteria in the blood (bacteremia) that often occurs with severe infections.A.D.A.M.

Causes, incidence, and risk factors

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:

• Confusion or other changes in mental status
• Red spots on the skin (petechiae and ecchymosis)
• Shock

There may be decreased or no urine output.

Signs 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

Expectations (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.

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).

Calling your health care provider

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

1. 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.
2. 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.
3. 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.

Review Date: 8/24/2011.

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.