I don't understand Sepsis?

  • Thread starter sameeralord
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In summary, Sepsis is an infection that causes systemic inflammation and can lead to septic shock if not properly treated. CRP increases with inflammation, and severe sepsis and septic shock are both conditions with high mortality rates.
  • #1
sameeralord
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Hello everyone,

I don't understand sepsis. Ok I know Sepsis is SIRS (Systemic inflammatory response syndrome) to an infection. But I'm confused with these scenarios.

1) Let's say I have a UTI in kidney. The immune system localises the infection to kidney and causes massive inflammation in that area and fights the disease, without allowing it to spread to otherarea. Now is this Sepsis? If it is not what do you call it? Here also inflammation towards infection occurs so why is it not called sepsis? Does CRP increase in this scenario?

2) Let's say I have a UTI in kidney. It spreads to all areas in body. Massive systemic inflammation occurs towards the infection. I'm assuming this is sepsis?, then what do you call scenario 1 I described. What happens to CRP in this condition.

3) You want inflammation and immune response against infections to fight them. So why is sepsis bad?

Thanks :smile:
 
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  • #2
Too much inflammatory response by the body can damage vital organs and cause death. That's why sepsis is bad. If a fever produces a body temp. > 106 F for extended periods, this can also cause damage to vital organs, including the brain. A little sepsis is OK, too much can be deadly.
 
  • #3
sameeralord said:
Hello everyone,

I don't understand sepsis. Ok I know Sepsis is SIRS (Systemic inflammatory response syndrome) to an infection. But I'm confused with these scenarios.

Close. Sepsis is SIRS + a source infection. SIRS criteria are 2+ of the following:
-temp >101 or <96.8
-tachycardia >90 bpm
-tachypnea >20
-PCO2 <32
-Hyperglycemia >120 (w/o DM)
-WBC >12000 or <4000

Thus SIRS is, itself nonspecific and can be caused by non-infectious pathology. When it is caused by infectious pathology and you have a source SIRS is sepsis. Vs consider, bacteremia which is just a +blood culture without necessarily meeting the conditions of SIRS.

Further sepsis is divided into sepsis, severe sepsis and septic shock.

Severe sepsis is defined by acute circulatory failure (SBP <90 or reduced >40 from baseline or lactate >2 which is evidence of severe hypoperfusion). Shock is when you meet the above and the patient fails to respond to adequate fluid resuscitation.

Kind of on the end of the SIRS spectrum would be Multiple organ dysfunction syndrome where you have the above +evidence of >2 organ systems failing.

sameeralord said:
1) Let's say I have a UTI in kidney. The immune system localises the infection to kidney and causes massive inflammation in that area and fights the disease, without allowing it to spread to otherarea. Now is this Sepsis? If it is not what do you call it? Here also inflammation towards infection occurs so why is it not called sepsis? Does CRP increase in this scenario?

You have a source, it depends on if you meet 2+ of the SIRS criteria listed above. If they don't have the criteria met above a "UTI in the kidney" would be called pyelonephritis.

sameeralord said:
2) Let's say I have a UTI in kidney. It spreads to all areas in body. Massive systemic inflammation occurs towards the infection. I'm assuming this is sepsis?, then what do you call scenario 1 I described. What happens to CRP in this condition.

Same as above. If they meet 2+ SIRS criteria and you know the source (the kidney infection in this case) then you meet criteria for sepsis. If its a massive spread of the infection and they have end organ failure, it would likely be severe sepsis or MOD syndrome.

On CRP: it is an acute phase reactant that becomes elevated with inflammation. When you have systemic inflammation it usually trends very high (>10).

sameeralord said:
3) You want inflammation and immune response against infections to fight them. So why is sepsis bad?

Thanks :smile:

In a clinical setting sepsis indicates an infection that has grown beyond the body's control. Acutely a patient can rapidly progress to shock or MODS and it has a high mortality rate if left untreated.

Yes you do want inflammation and a immune response locally, but this can get out of control. Local cytokines ideally activate an immune response to do with the insult. However, if that doesn't clear the infection, cytokines end up in the blood stream to try and improve the local response (growth factors, better white cell recruitment, B-cell activation etc). Normally the body decreases proinflammatory agents at this point and the infection gets resolved and homeostasis is restored. If it doesn't the immune response (cytokines, interluekins etc) can get "carried away" and you can have a runaway inflammatory response. This is dangerous to the patient and requires intervention normally for a patient to survive.
 
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  • #4
Thanks :smile: I get it now
 
  • #5


Hello,

Sepsis is a complex medical condition that occurs when the body's response to an infection becomes dysregulated, leading to widespread inflammation and organ dysfunction. It is a serious and potentially life-threatening condition that requires prompt medical attention.

To answer your questions, in scenario 1 where the UTI is localized to the kidney and the immune system is able to contain and fight the infection, it is not considered sepsis. Sepsis occurs when the infection spreads throughout the body and triggers a systemic inflammatory response, causing damage to multiple organs. In this scenario, CRP levels may increase, but it is not necessarily indicative of sepsis.

In scenario 2, where the UTI has spread to all areas of the body and caused widespread inflammation, this would be considered sepsis. In this case, CRP levels may also be elevated as a result of the systemic inflammation.

Sepsis is considered bad because it can lead to organ dysfunction and failure, which can be life-threatening. While inflammation and immune response are necessary for fighting infections, in sepsis, these responses become excessive and can cause harm to the body.

I hope this helps to clarify your understanding of sepsis. It is a complex condition and if you have any further questions, please consult with a medical professional.
 

1. What is Sepsis?

Sepsis is a serious condition that occurs when the body's response to an infection triggers widespread inflammation. This inflammation can lead to organ dysfunction and potentially life-threatening complications.

2. What are the symptoms of Sepsis?

The symptoms of Sepsis can vary, but may include fever, rapid heart rate, rapid breathing, confusion, extreme fatigue, and decreased urine output. In severe cases, Sepsis can also cause organ failure and shock.

3. How is Sepsis diagnosed?

Sepsis is usually diagnosed through a combination of physical examination, medical history, and laboratory tests. These tests may include blood cultures, imaging studies, and measuring levels of certain biomarkers in the blood.

4. What causes Sepsis?

Sepsis is primarily caused by bacterial, viral, or fungal infections. These infections can occur anywhere in the body, but most commonly originate in the lungs, urinary tract, skin, or abdominal organs. In rare cases, Sepsis can also be caused by parasites or other non-infectious triggers.

5. How is Sepsis treated?

Treatment for Sepsis usually involves addressing the underlying infection with antibiotics or antifungal medication. Supportive care, such as oxygen therapy and intravenous fluids, may also be necessary to stabilize the patient. In severe cases, patients may require admission to the intensive care unit for close monitoring and specialized treatment.

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