For patients with possible signs of sepsis, there are a number of blood tests that can be utilized. Even though these tests cannot diagnose sepsis, combining the results with other information can help.
Often, sepsis arises due to the failure to treat an infection quickly enough, or when a patient has undergone an operation and harmful bacteria have entered the bloodstream during surgery. However, sometimes sepsis itself can be misdiagnosed by medical professionals.
Of patients who experience sepsis, the estimated proportion with a missed or delayed diagnosis ranges between 8.2% and 20.8% (8, 9). In an effort to help with early detection, researchers have redefined sepsis (10) and validated criteria for identifying high-risk patients.
Sepsis usually produces an elevated white blood cell count, with an increased number of neutrophils and an increased percentage of immature forms called bands (ie, a left shift, or bandemia) (Munford, 2008). The absence of an elevation of the white blood cell count does not rule out sepsis.
The CBC of a patient with sepsis is commonly characterized by lymphocytopenia, neutrophilia, eosinopenia, thrombocytopenia, increased RDW, and increased NLR (Figure 2). The importance of thrombocytopenia in patients with sepsis is emphasized by the inclusion of platelet count in the SOFA score.
a wound culture – where a small sample of tissue, skin or fluid is taken from the affected area for testing. respiratory secretion testing – taking a sample of saliva, phlegm or mucus. blood pressure tests. imaging studies – like an X-ray, ultrasound scan or computerised tomography (CT) scan.
There is no definitive diagnostic test for sepsis. Along with clinical data, laboratory testing can provide clues that indicate the presence of or risk of developing sepsis. Serum lactate measurement may help to determine the severity of sepsis and is used to monitor therapeutic response.
Although 28%-49% of cases of severe sepsis in adults have been described to be culture-negative, data are limited on the epidemiology and outcomes in the pediatric population of those with culture-negative severe sepsis (CNSS) [12].
Complete blood count (CBC): A CBC is a common blood test. It measures how many white blood cells are circulating in your blood, among other things. White blood cells (also called leukocytes) fight bacteria, viruses, and other organisms your body identifies as a danger.
In laboratory tests, sepsis often coincides with high white blood cell counts. But in the highly acute phase, and especially in immunocompromised patients, there may also be a decrease in white blood cell counts.
Sepsis can be difficult to diagnose immediately, which makes general awareness about it all the more important.
Recovering from sepsis
Most people make a full recovery from sepsis. But it can take time. You might continue to have physical and emotional symptoms. These can last for months, or even years, after you had sepsis.
Research conducted at the Institute of Healthcare Policy and Innovation at the University of Michigan shows that many people die in the months and years following sepsis diagnosis and treatment. Forty percent of the study subjects who survived the first 30 days under hospital care died within two years.
Many conditions mimic sepsis by meeting criteria for SIRS.
These conditions include: pulmonary embolism (PE), adrenal insufficiency, diabetic ketoacidosis (DKA), pancreatitis, anaphylaxis, bowel obstruction, hypovolemia, colitis, vasculitis, toxin ingestion/overdose/withdrawal, and medication effect.
Without treatment, most people with more serious stages of sepsis will die. Even with treatment, 30% to 40% of people with septic shock, the most severe stage of sepsis, will die.
If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc. Sometimes however, you may have an infection and not know it, and not have any symptoms.
How Quickly Can Sepsis Develop? Sepsis can develop quickly from initial infection and progress to septic shock in as little as 12 to 24 hours.1 You may have an infection that's not improving or you could even be sick without realizing it.
While the risk of mortality increases with severity of SIRS, a large portion of patients (30 – 60%) fail to demonstrate a culture proven source of infection (culture negative sepsis).
If you have mild sepsis, you may receive a prescription for antibiotics to take at home. But if your condition progresses to severe sepsis, you will receive antibiotics intravenously in the hospital. This method helps the medicine get into your bloodstream quicker so it can fight the infection sooner.
It's clear that sepsis doesn't occur without an infection in your body, but it is possible that someone develops sepsis without realizing they had an infection in the first place.
A person with sepsis might have one or more of the following signs or symptoms: High heart rate or weak pulse. Fever, shivering, or feeling very cold. Confusion or disorientation.
If left undiagnosed, sepsis can lead to tissue death or gangrene and may result in an amputation. This could mean losing fingers or toes or, to save their life, larger limbs may need to be removed. Sadly, this surgery often has a significant impact on the patient's future lifestyle.
The early symptoms of sepsis include: a high temperature (fever) or, due to changes in circulation, a low body temperature instead. chills and shivering.