Yet early detection can be difficult. 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.
A missed sepsis diagnosis can make a person very sick, can lead to organ failure, or it can be fatal. Each year many people file claims with the court citing medical malpractice and misdiagnosis.
Out of 1,945 patients admitted with severe sepsis/septic shock, 158 (8.1%, 95% CI: 6.9, 9.4%) had potentially missed sepsis during an antecedent treat-and-release ED visit.
Sepsis is often misdiagnosed because the sufferer is not thoroughly assessed or the symptoms are misinterpreted.
In one telephone survey of more than 1,000 hospital physicians in Europe and the United States, half of whom were intensive care specialists, 86% stated that that the symptoms of sepsis could easily be misattributed to other conditions, and 45% felt that they sometimes missed a diagnosis of sepsis [20].
Sepsis can be difficult to diagnose immediately, which makes general awareness about it all the more important. “It is one of the leading causes of death in the United States, on par with cancer and heart disease,” says Yale Medicine emergency physician John Sather, MD.
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.
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.
For instance, a patient with severe influenza, malaria, or viral haemorrhagic fever may be septic on presentation, but does not have sepsis as per the definition.
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 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.
Examples of sepsis misdiagnosis
Sepsis can often be misdiagnosed due to the following: Blood pressure was not obtained promptly. Serum lactate and full blood count was not measured. Symptoms of sepsis are missed or misinterpreted.
Sepsis is treatable if it's identified and treated quickly. In most cases it leads to full recovery with no lasting problems.
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.
Late-onset sepsis occurs at 4-90 days of life and is acquired from the environment. Organisms that have been implicated in late-onset sepsis include the following: Coagulase-negative Staphylococcus. Staphylococcus aureus.
Organ damage and organ failure can result. The most common infections include pneumonia and infections of the urinary tract, skin and gut, the CDC said in its report. There is no specific test for sepsis and symptoms can vary, which means it is often missed.
It's important to remember that not everyone who gets sepsis has a high temperature or fever. So if you feel very unwell but have a normal temperature you should still speak to your healthcare professional.
When treatment or medical intervention is missing, sepsis is a leading cause of death, more significant than breast cancer, lung cancer, or heart attack. Research shows that the condition can kill an affected person in as little as 12 hours.
As sepsis worsens or septic shock develops, an early sign, particularly in older people or the very young, may be confusion or decreased alertness. Blood pressure decreases, yet the skin is paradoxically warm. Later, extremities become cool and pale, with peripheral cyanosis and mottling.
Sepsis can start gradually, or the symptoms can come on very suddenly. Sepsis must be treated quickly and efficiently as soon as healthcare providers suspect it. If it isn't recognized and treated quickly, sepsis can progress to severe sepsis and then to septic shock.
The condition can arise suddenly and progress quickly, and it's often hard to recognize. Sepsis was once commonly known as “blood poisoning.” It was almost always deadly. Today, even with early treatment, sepsis kills about 1 in 5 affected people.
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. And sometimes, doctors never discover what the initial infection was.
One of the most common manifestations of sepsis is increased respiratory rate. Tachypnoea (a hallmark of sepsis-induced adult respiratory distress syndrome) can be associated with abnormal arterial blood gases, typically, a primary respiratory alkalosis.