Blood poisoning

Synonyms

Medical:

• sepsis
• Septicemia
• Bacteremia

In a broader sense:

• Sepsis Syndrome
• Septic shock
• SIRS (systemic inflammatory response snydrome)
• Systemic Inflammatory Response Syndrome

Definition and introduction

At a Blood poisoning (sepsis) it comes from pathogens and their products that enter the Bloodstream have penetrated and also colonized organs, to a systemic combat reaction of the entire organism with the uninhibited release of substances that activate the coagulation, defense and inflammatory systems. It is life-threatening and can with you Multiple organ failure accompanied.

The pathogens are usually bacteria. A Blood poisoning (sepsis) is a dangerous and feared complication of a wide variety of diseases.
Such reactions can also be due to other causes such as Burns, Traumas or toxins are triggered. This is known as SIRS (systemic inflammatory response syndrome). This is an umbrella term that means an inflammatory reaction that affects the entire organism, can have various causes and is associated with end organ damage. Blood poisoning is the most common cause of SIRS and is triggered by pathogens (usually bacteria).

Frequency of blood poisoning

In Germany, one assumes about annually 100.000 – 150.000 sick people, women seem to be slightly less affected. The information on lethality varies between values ​​of 25% to 50% and is certainly dependent on the type of pathogen, the severity of the disease and the start of therapy.
A Blood poisoning (sepsis) is often a result of previous infections of certain organs. The most common precursor of blood poisoning is one lung infection (44%) followed by Urinary tract infections (10%) and infections of the abdominal organs (10%). Finally, infections of wounds or soft tissues should be mentioned (approx. 5%), e.g. after burns, operations or injuries.

Disease emergence

The body's defense cells react to blood poisoning with a very strong defense reaction. Usually the pathogens are bacteria that enter the body through an entry port. After overcoming the local defenses, they enter the bloodstream. Inflammation is triggered. The bacteria themselves or their breakdown products or the toxic substances (toxins) they release can have an inflammatory effect. Certain defense cells, the phagocytes (monocytes / macrophages), release certain substances (cytokines) after their activation through contact with the pathogens, which, in high doses, can have a direct damaging effect on the tissue and, on the other hand, further promote the inflammatory reaction activate further defense cells (e.g. granulocytes), which in turn release substances that promote inflammation. These substances are cytokines. It is understood to mean proteins that stimulate certain target cells to grow, develop and multiply.

In the case of blood poisoning, these cytokines produce massive tissue-toxic substances during this strong defense reaction. These toxic substances include free oxygen radicals and nitric oxide (NO). In addition, the cytokines also cause the target cells to release certain mediators, i.e. messenger substances that act on the various layers of the blood vessels and cells or tissues. The structure and function of the smallest vessels are changed. So they can expand and the walls become more permeable. As a result, fluid passes into the surrounding tissue (interstitial edema). The coagulation system is also activated. The blood's willingness to clot is changed and clots form. The blood circulation cannot be adequately guaranteed, the tissue is undersupplied with oxygen, which is called ischemic-hypoxic cell damage.
But not only the smallest blood vessels are affected. The larger and larger vessels also dilate, especially in peripheral regions, e.g. arms and legs, which in turn affects blood pressure. At the beginning, the body counteracts this drop in resistance with an accelerated heartbeat (palpitations) and thus increased blood ejection volume in order to maintain blood pressure. After a while, when the heart muscle is also attacked, the body can no longer compensate for this, however, and blood pressure drops. Since the heart muscle is also affected by the undersupply, the tissues can increasingly no longer be supplied until a shock occurs.

Read more about the precursor of blood poisoning: Bacteremia - when bacteria get into the blood

How can I recognize blood poisoning?

There are several symptoms that can occur as part of blood poisoning. Nonetheless, blood poisoning is often not easy to see. An infection is a prerequisite for the development of blood poisoning. But even this does not necessarily have to be noticed by the person concerned.
When fever and increasing Deterioration in general condition a doctor should therefore be consulted promptly. The doctor can diagnose blood poisoning using a physical examination, blood tests, ultrasound and X-ray examinations.

Symptoms of blood poisoning

Blood poisoning is always caused by an infection. For example, an infected wound can be the trigger. However, there are numerous other possible infections as well. Such an infection is often initially not even noticed by the person concerned if it takes place in the body and is not obvious, such as a wound.
If blood poisoning is present, the affected person usually develops fever, often with chills. It can also become a Acceleration of breathing come. A healthy person breathes in and out about 12 times a minute. In the case of blood poisoning, the breathing rate is often more than 20 breaths per minute (Tachypnea). Also the Heart rate which is usually between 60 and 100 beats per minute can be over 100 beats per minute (Tachycardia).
Furthermore, a low blood pressure (Hypotension) and States of confusion occur. The person concerned usually feels exhausted, significantly reduced in performance and is easily tired.

Fever associated with blood poisoning

Fever is one of the Main symptoms of blood poisoning. The temperatures are then over 38 degrees Celsius. Often times the fever is also from chills accompanied. Fever is a very common occurrence in blood poisoning, but it is not a mandatory criterion. So there are also blood poisonings that proceed without a fever. Undertemperature, i.e. a body temperature below 36 degrees Celsius, can also occur in sepsis, but this is much less common than fever.

Diarrhea from blood poisoning

Diarrhea is not a typical symptom blood poisoning. Persistent diarrhea, which is accompanied by symptoms such as fever, fatigue and other symptoms such as low blood pressure, high pulse or rapid breathing, can in some cases be an indication of the presence of blood poisoning as part of a gastrointestinal tract infection.

Pain from blood poisoning

There is also pain not a typical symptom blood poisoning. However, if the blood poisoning comes from an infected wound, for example, this can be accompanied by severe pain.

Red line for blood poisoning

Of the myth from the red line that slowly spreads and heralds death when it has reached the heart, holds up well and is associated with blood poisoning. Much of that myth is, however medically incorrect.
The disease, which is described by the red line on the skin, is an inflammation of one or more lymph vessels. One speaks of one in medical jargon Lymphangitis. Confusingly, this condition is also sometimes popularly referred to as blood poisoning. The disease is relatively rare and occurs when (bacterial) pathogens enter the lymphatic system. This is treated with antibiotics and cooling. It is not true that the proximity of the line to the heart has something to do with how likely it is to die.

Classification of blood poisoning

The is divided Blood poisoning according to the severity in the following stages:

• Blood poisoning (Sepsis)
• severe blood poisoning (with organ dysfunction)
• more septic shock

In addition to the classification according to the severity of the blood poisoning, they can also be classified according to the type of pathogen, the location of the entry port or the source of the blood poisoning.

The septic shock

Septic shock is a complication of blood poisoning. Sepsis is popularly referred to as blood poisoning, so a septic shock means a shock due to blood poisoning. With shock it is meant that the body is so weakened by the invading pathogens that it can no longer adequately maintain its functions. It comes to a massive one Drop in blood pressure, is usually the same time Pulse (Heart rate) clearly elevatedto compensate for low blood pressure.

Septic shock is one acutely life-threatening situation and must be treated in an intensive care unit. In most cases, the patient is artificially ventilated and treated with medication designed to raise the blood pressure, which is much too low. Antibiotic treatment is also carried out. This is used to treat the infection that originally caused the blood poisoning to develop.
Septic shock is a serious complication, and adequate treatment is often no longer possible for it to result in leads to death in over half of the cases.

Entry gates

In order to get into the body or into the bloodstream, the pathogens have various options:

• Wounds of the skin, Surgical wounds, burns
• Gastrointestinal tract included Biliary tract
• Ear, nose and throat area
• genitals
• Urinary system

After the pathogens have overcome the local defenses at the portal of entry, they enter the bloodstream.

Wound infections as a cause of blood poisoning

The cause of blood poisoning is always one infection. There are many different types of infections. Infections that most commonly lead to sepsis are Pneumonia and Urinary tract infections.
But wound infections are also not infrequently a trigger for blood poisoning. A wound infection can occur when an existing wound becomes infected. This happens because pathogens (mostly bacteria) penetrate the wound. As the disease progresses, the pathogens also enter the bloodstream, which is then referred to as blood poisoning.

Blood poisoning after a mosquito bite

That blood poisoning develops from an insect bite Rare, but theoretically possible. This can happen because bacterial pathogens enter the body through the small lesion caused by the sting and enter the bloodstream. If blood poisoning occurs from an insect bite, one is required antibiotic treatment.

• Blood poisoning after an insect bite
• Inflammation after a mosquito bite

Blood poisoning after an operation

During operations, pathogens can enter the body through the area to be operated on. Although this is attempted to be avoided by working in a sterile manner, it cannot be completely prevented. Therefore, every year there are numerous cases of blood poisoning developing after an operation.

Blood poisoning agent

The most common cause of blood poisoning are bacteria. From the multitude of different pathogens, the most common are mentioned here:

• Staphylococci (Staphylococcus aureus)
• Streptococci
• E. coli
• Enterobacter spp
• Pseudomonas aeruginosa

Almost every pathogen can cause blood poisoning (sepsis) cause. This is u. a. depends on the defenses of the person concerned.
Blood poisoning caused by fungi is less common. But they play an important role in patients whose immune system is degraded. This is the case with infections such as AIDS or as therapy for transplants (e.g. of the bone marrow).

Hospital germs can also cause blood poisoning.

Treatment of blood poisoning

The treatment of blood poisoning is done with Antibiotics, i.e. drugs that are supposed to work against bacteria. There are many different bacteria, and not every antibiotic is effective against all bacteria. Therefore, a blood sample, known as a blood sample, is usually taken from a patient with blood poisoning before starting drug therapy Blood culture. This blood culture is then searched for pathogens in the laboratory. This usually takes a few days. However, as antibiotic treatment for blood poisoning should be started immediately after diagnosis, a drug that can fight many bacteria at once is usually used first. If the results of the blood culture are there, antibiotic therapy can be started customized become.
Depending on the severity of the blood poisoning, other drugs are used. For example, those that stabilize blood pressure.

Antibiotics

Antibiotics play an essential role in treating blood poisoning and should be used immediately after diagnosis. How long antibiotic treatment is necessary depends on the type and severity of the infection.

Duration of blood poisoning

The duration of blood poisoning cannot be quantified across the board. It largely depends on when therapy is started, how severe the infection is, whether complications occur, how well the treatment works and what the general condition of the person affected is.
In some patients, antibiotic treatment is sufficient 7-10 days off, then the infection has subsided and the blood poisoning treated. However, there are also courses that are associated with complications, require intensive medical treatment and become over Months drag on.

Blood poisoning

The course of blood poisoning depends on the extent of the disease and the general condition of the patient. The course is also significantly influenced by how quickly treatment is initiated. If drug treatment using antibiotics is not initiated in good time or if the person's immune system is already significantly impaired before the blood poisoning, blood poisoning can be fatal.
Blood poisoning is the third most common cause of death. But with timely and adequate treatment, blood poisoning can go well without the occurrence of complications and those affected do not retain a deficit.

Risk factors (predisposition)

Particularly at risk of blood poisoning (sepsis) are people whose immune system is degraded. These include diabetics (Diabetes mellitus), Patients with tumors or liver- and Kidney disease Suffer. People whose immune system as a result of a AIDS disease is weakened. A weak immune system can also be the result of a therapy with suppression of the immune system (immunosuppression therapy). This is e.g. the case with transplants. Patients after trauma or surgery are also at increased risk of developing blood poisoning. Also from inflammations that seem harmless at first, such as those of the respiratory tract, des Gastrointestinal tract or the urinary tract can develop into blood poisoning.