When inflammation isn’t controlled, mild sepsis can become severe and lead to septic shock. This is when blood pressure drops to a dangerous low, raising the risk for multiple organ failure and even death. (1) This condition can happen to anyone, but certain people are at greater risk. For this reason, getting ahead of sepsis and protecting yourself involves an understanding of its causes and risk factors. Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi. Signs of pneumonia include a fever, coughing, shortness of breath, and chest pains. These infections are normally treated with an antibiotic, antiviral, or antifungal medication. (3) Some bouts of pneumonia respond well to medication, while others don’t. When medication proves ineffective, the infection can lead to widespread inflammation and sepsis. Urinary tract infections can also become a serious health concern when the infection isn’t treated quickly or doesn’t respond to medication. A UTI can spread to the kidneys and progress to a secondary infection localized in the urinary tract, called urosepsis. About half of urosepsis cases in older adults are caused by a UTI. (4) But while pneumonia and a urinary tract infection are common causes of sepsis, these aren’t the only types of infections that can become deadly. For example, some people are diagnosed with sepsis after a gastrointestinal infection, like from certain strains of Escherichia coli (E. coli). (5) This bacteria normally lives in the intestines, but you can get sick if you eat food or touch an object contaminated with harmful strains of E. coli. This infection — which causes nausea, vomiting, and a fever — are usually harmless. But some E. coli infections, which can create toxins, become serious and lead to sepsis. (5) Peritonitis is another infection of the gut that can lead to sepsis. This type of infection can be the result of gastrointestinal perforation, although there are other possible causes as well. (6) A gastrointestinal (GI) perforation is when a hole develops in the GI tract due to an inflammatory condition, such as diverticulitis, ulcerative colitis, and Crohn’s disease. Because of this hole, contents of the GI tract can seep into the abdomen and cause an infection. If not treated, these infections can lead to sepsis. (6) Skin infections can also turn into sepsis. Keep in mind that these infections don’t have to start off serious to become life-threatening. (7) Something as simple as a bug bite or a cut can become infected and advance to sepsis. The bacteria Staphylococcus aureus (staph or MRSA) can live on the body without causing problems. But if you have a skin wound, a bug bite, or a burn on your skin, the staph bacteria can enter your bloodstream through the wound and cause a serious infection. (8) Other infections associated with sepsis include: (9)
AppendicitisGallbladder infectionCellulitisPost-surgery infectionsBone infectionsHeart infectionsMeningitisEncephalitis
Here is a look at six risk factors for sepsis:
1. Having a Chronic Condition
Being critically ill or being previously diagnosed with other medical issues is one risk factor. In fact, “sepsis is more common in people who have multiple health problems,” explains Dr. Brown. This includes conditions like cancer, high blood pressure (hypertension), diabetes, kidney disease, and HIV or AIDS. (1) The connection between chronic illnesses and sepsis has everything to do with the immune system. Illnesses that are persistent and long-lasting can put too much stress on the body. “Chronic disease wears on our body’s immune system and makes it more difficult for our body to mount a defense against infections,” continues Brown. And when the body’s defenses are weakened, there’s a greater risk for a sepsis. (10) Take the HIV virus, for example. The virus attacks cells and reduces the immune system’s defenses. (11) And if you have diabetes, poor blood flow puts you at risk for nonhealing wounds, which can give rise to skin infections that lead to sepsis. (12) Or, if you’re diagnosed with cancer, certain treatments designed to target and destroy malignant cells (chemotherapy) can weaken your immune system in the process. (1) As a result, the risk for infections and complications multiplies.
2. Age
Age is another risk factor for sepsis. Although sepsis can happen to anyone, Brown warns that the condition is also common in the older population, particularly due to the link between age and chronic illnesses. (1) “As we get older, we are more prone to having chronic diseases, like high blood pressure, COPD, congestive heart failure, diabetes, and obesity,” she says. She further notes another danger that comes with age. “In the elderly, it can also be difficult to detect sepsis, as some people may not be able to mount fevers, are on medication, or have had procedures that make them unable to have an elevated heart rate.” “Without the usual vital signs that may clue us into sepsis, we as physicians have to dig deeper and be more vigilant about detecting sepsis in these patients.” The elderly aren’t the only ones at risk for sepsis. Babies and infants also have a high risk because of their weaker immune systems, particularly children younger than 1 year old. (2)
3. Treatment in the Intensive Care Unit (ICU)
“ICUs provide critically ill patients with care, but their underlying problems may predispose them to sepsis,” warns Keith Roach, MD, an internist at New York-Presbyterian Hospital and Weill Cornell Medical Center in New York City. “Heart failure and liver disease each increase risk of sepsis through different mechanisms, and most ICU patients have lines or tubes that bypass normal skin barriers, allowing bacteria (often drug-resistant) to come in,” he continues. So while invasive mechanisms like catheters and breathing tubes can provide life-saving treatments, they also provide a portal of entry for bacteria into the body. (1) Antibiotics fail to work for numerous reasons. Some people don’t take their full course and stop taking the drug once they feel better. This is dangerous because stopping an antibiotic early can cause a recurrent infection. Additionally, some research suggests that stopping treatment early also encourages antibiotic resistance, although more studies are needed. (13) Antibiotic resistance is when bacteria changes and no longer responds to certain antibiotics, allowing the spread of infections with fewer options for treatment. See a doctor if you receive antibiotic treatment but your infection doesn’t improve or worsens. Some women come down with sepsis from an infection not related to their pregnancy, such as pneumonia or a UTI. Pregnancy-related sepsis can be caused by complications like: (14)
MiscarriageCesarean sectionNonsterile abortionProlonged laborInfection after a vaginal deliveryBreast infectionRuptured membranes
Because chronic illnesses can further weaken the immune system, the risk of nonpregnancy- and pregnancy-related sepsis is greater in women who have diabetes or receive invasive tests while pregnant. (14) Be mindful of the fact that it’s sometimes difficult to identify sepsis in women who are pregnant or have recently given birth. Some symptoms of sepsis mimic those that women commonly experience before and after delivery, such as a change in blood pressure and a faster heartbeat. (14) Along with pregnant women being at risk for sepsis, newborns are also at risk. Neonatal sepsis can develop within the first three days of life. It is usually caused by bacteria that transfers from mother to infant before or during delivery. (15)
6. Ignoring an Infection
Sepsis may also occur if you ignore warning signs of an infection — no matter the type. Some people put off going to the doctor when they feel ill, thinking they can treat their symptoms at home. But while some illnesses can be self-treated at home, infections often require medication to avoid complications. Signs of an infection vary depending on the type. Whereas a UTI can cause painful urination, bloody urine, and flank pain, a skin infection may cause a swollen lump, an abscess or boil, or a painful rash. But a serious infection that requires medical attention often causes a high fever, shivering, dizziness, and low blood pressure.
The Importance of Being Proactive When It Comes to Detecting Sepsis
Sepsis is scary, especially because it can happen to anyone. But understanding the causes and knowing your risk is how you protect yourself. Remember, infections can progress rapidly. So, it’s also important not to ignore signs of an infection. Doing so can cause your immune system to go into overdrive, triggering widespread inflammation. And when this happens, sepsis can lead to septic shock. Therefore, be proactive about your health.
