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Septic Shock

Definition

Septic shock occurs when overwhelming infection of the bloodstream causes dilated and leaky blood vessels, resulting in turn in blood pressure too low to adequately supply the tissues with needed oxygen and nutrients. It is a life-threatening condition.

What is going on in the body?

Shock is a word used to describe a certain abnormal state in the body. In this state, the body's circulation does not supply enough blood and oxygen to vital organs, such as the kidneys and the brain. Shock can have several different causes. One of the causes of shock is sepsis, a serious infection that involves the blood. This type of shock is known as septic shock.

Risks

What are the causes and risks of the condition?

An infection almost anywhere in the body can spread into the bloodstream and cause septic shock. Most cases start as infections in the lungs, kidney, or gut. Sometimes, the original source of the infection cannot be identified. Septic shock is often fatal despite appropriate treatment.
Lung, heart, kidney, brain, and other organ damage may also occur. This damage is often reversible with treatment, though it can be permanent in severe cases.

Prevention

What can be done to prevent the condition?

Some cases cannot be prevented. Early treatment of infections can prevent many cases. Immunizations should be obtained as advised.

Diagnosed

How is the condition diagnosed?

The diagnosis is often suspected after a history and physical examination, often in the emergency department. The diagnosis can often be confirmed by drawing a blood sample for a blood culture. If the sample contains bacteria and the person is in shock, septic shock can usually be diagnosed with certainty.
In some cases, bacteria cannot be found in the blood, at least not at the particular time the cultures were drawn. A person may still be treated for septic shock in this case based on the history, examination, and other blood and urine tests or X-rays.

Long Term Effects

What are the long-term effects of the condition?

Death may happen quickly without treatment. Other permanent organ damage can occur in severe cases.

Other Risks

What are the risks to others?

Some of the infections that cause septic shock are contagious, such as pneumonia. Others, such as urinary tract infections, usually are not contagious.

Treatments

What are the treatments for the condition?

A person in shock usually needs to be treated in a hospital's intensive care unit or ICU. Antibiotics and fluids are given through an intravenous or IV as soon as the diagnosis is made.
Very sick people may need to be put on an artificial breathing machine, a ventilator for a period of time. Medications may be needed to keep the blood pressure from getting too low. Surgery may be required in some cases, such as for some infections that started in the gut.

Side Effects

What are the side effects of the treatments?

All medications may cause side effects. Antibiotics can cause allergic reactions, stomach upset, and other side effects. Other effects depend on the medicines used. A ventilator can rarely cause a new infection or lung damage. Surgery can be complicated by bleeding, infection, an allergic reaction to the anesthetic, or even death.

After Treatment

What happens after treatment for the condition?

Septic shock may cause death even with the best treatment available. Many cases can be treated, and most people have a full recovery. If a person recovers, he or she is usually sent home and can return to normal activities. Permanent disabilities can rarely occur from septic shock and may require ongoing treatment.

Monitor

How is the condition monitored?

Symptoms and physical examination are followed. Blood and urine tests and X-rays may also be needed in many cases for monitoring.

Sources

Cecil Textbook of Medicine, 1996, Bennett et al.

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