Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses.
Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage, and may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.
The body also produces a strong inflammatory response to the toxins. This inflammation may contribute to organ damage.
Risk factors for septic shock include:
Diabetes
Diseases of the genitourinary system, biliary system, or intestinal system
Diseases that weaken the immune system such as AIDS
Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters and plastic and metal stents used for drainage)
Leukemia
Long-term use of antibiotics
Lymphoma
Recent infection
Recent surgery or medical procedure
Recent use of steroid medications
Symptoms
Septic shock can affect any part of the body, including the heart, brain, kidneys, liver, and intestines. Symptoms may include:
Cool, pale extremities
High or very low temperature, chills
Lightheadedness
Low blood pressure, especially when standing
Low or absent urine output
Palpitations
Rapid heart rate
Restlessness, agitation, lethargy, or confusion
Shortness of breath
Skin rash or discoloration
Signs and tests
Blood tests may be done to check for infection, low blood oxygen level, disturbances in the body's acid-base balance, or poor organ function or organ failure.
A chest x-ray may show pneumonia or fluid in the lungs (pulmonary edema).
A urine sample may show infection.
Additional studies, such as blood cultures, may not become positive for several days after the blood has been taken, or for several days after the shock has developed.
Treatment
Septic shock is a medical emergency. Patients are usually admitted to the intensive care unit of the hospital.
Treatment may include:
Breathing machine (mechanical ventilation)
Drugs to treat low blood pressure, infection, or blood clotting
Fluids given directly into a vein (intravenously)
Oxygen
Surgery
There are new drugs that act against the extreme inflammatory response seen in septic shock. These may help limit organ damage.
Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -- may be required. This can only be done with special equipment and intensive care nursing.
Expectations (prognosis)
Septic shock has a high death rate. The death rate depends on the patient's age and overall health, the cause of the infection, how many organs have failed, and how quickly and aggressively medical therapy is started.
Complications
Respiratory failure, cardiac failure, or any other organ failure can occur. Gangrene may occur, possibly leading to amputation.
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