Septicemia (blood poisoning infection) - a severe pathological condition, which is described as finding the causative agent (microbe or fungus) in the blood.
The development of sepsis is a life-threatening condition and untimely treatment can lead to loss of life.
Causes
Pathogens may become pathogenic microbes or fungi. The basic microbial agents are:
- Pseudomonas aeruginosa, pathogenic strains of aureus,
- pathogenic strains of E. coli,
- pneumococcus, meningococcus, Klebsiella,
- tuberculous mycobacteria,
- In rare cases, sepsis can occur caused by the fungi Candida species or other fungi.
The process develops in the case of reduction of total body resistance to infection, chronic depletion of the immune system infectious processes or the presence of purulent foci, in the case of reduction of the protective functions of natural barriers - the skin, the intestine, lungs.
As a result, the body can not locate and destroy microbes, they are free to enter the bloodstream, while while in the blood, due to impaired immunity, reduced number of components and the immune bactericidal cells.
In each case, the primary foci of infection may be different - from carious teeth and tonsils until abscesses in the abdominal cavity and pyogenic skin wounds.
Typically, sepsis occurs
- at diabetes,
- at oncological diseases
- at rickets or immunodeficiency (congenital or acquired)
- in severe trauma or burns
- Propafenone or immunosuppressors for extended X-ray and chemotherapy.
Kinds
There are several types of sepsis, which differ in the mechanism of development and types of pathogens:
- Cutaneous sepsis - foci of infection primarily occur on the skin (burns, wounds, purulent processes).
- Oral (oral) sepsis - primary foci located in the mouth or throat (cavities, pulpitis, osteomyelitis jaw, tonsils, retropharyngeal abscesses).
- Obstetric (gynecological) with primary foci in the uterus or genital area after childbirth, in inflammatory processes pelvis.
- Otogenny sepsis, with primary focus in the area of the middle ear or close to it.
- Surgical (diagnostic) - occurs after surgery or infection with drift after diagnostic procedures.
- Cryptogenic, with unknown or obscure the primary site of infection.
- Nosocomial sepsis - a particular condition characterized by infection with virulent strains of bacteria that are resistant to therapy.
It is extremely important to determine "entrance gate" or the primary focus of sepsis, as this gives a clue to the causes infection and exemplary list of possible pathogens, and thus allows you to select the most effective therapy.
Features sepsis
Unlike conventional infections, sepsis has particular flow conditions. It is characterized by:
- The obligatory presence of the primary tumor, even of unknown, but it has always been. Moreover, this center should be closely related to the blood or lymphatic routes.
- In sepsis pathogen must repeatedly penetrate into the blood (this condition is called septicemia).
- Characterized by the formation of secondary infectious lesions, in which the pathogen multiplies and again enters the blood (pyosepticemia).
- The body is unable to provide adequate immune response to the infection and activate defense responses of cells and tissues against pathogens.
Only if all of these conditions exhibited a diagnosis of sepsis.
manifestations of sepsis
The symptoms of sepsis are largely dependent on the primary lesion and exciter type, but for the septic process is characterized by several clinical symptoms typical:
- severe chills,
- fervescence (permanent undulation or associated with the new blood entering the exciter portion)
- strong sweating with the change of a few sets of clothes per day.
These are the three main symptoms of sepsis, they are the most constant development process. They may in addition be:
- pale skin and mucous membranes, waxy complexion,
- fatigue and apathy of the patient, changes in the psyche from euphoria to severe lethargy and stupor
- sunken cheeks with a strong blush on the cheeks against the general pallor,
- hemorrhages in the skin in the form of spots or strips, particularly in the hands and feet,
- gerpesopodobnye sores, bleeding of mucous membranes,
- respiratory failure, reduction in pressure,
- compaction or pustules on the skin,
- decrease in urine volume.
during sepsis
The process may be developed in the following scenarios:
- lightning fast - growing for 1-3 days,
- acute - develops after 4-60 days after the formation of the primary tumor,
- subacute - lasts for two to six months,
- chronically - it lasts for more than six months,
- Relapsing - alternating periods of sepsis with periods of complete health.
Diagnostics
The diagnosis is established when there is a typical picture of sepsis with evidence of its laboratory data.
Performed blood cultures and discharge of inflammation. Holding crops to the discovery of the causative agent should be repeated, since pathogens there life cycles, and the therapy can significantly change the picture of the blood and the level of germ in it.
When detected in the blood and the content of the primary focus of similar microbes, the diagnosis is confirmed.
To clarify the treatment is carried out also to determine the sensitivity of bacteria to antibiotics.
Furthermore, conducted general blood analysis with detection inflammatory picture, biochemical blood analysis with detection of inflammatory changes, gas composition, electrolyte composition and its clotting.
Carry chest x-ray, ultrasound examination of internal organs with searching primary sites of infection.
sepsis treatment
Sepsis is treated only in the infectious or therapeutic hospital, in the intensive care unit.
The principles of treatment are similar to the treatment of other foci of infection, but takes into account the general grave condition and risk of death.
apply:
- antibiotics maximum doses in view of sensitivity, intravenously.
- conduct an active struggle with toxemia,
- activate the body's own immune system, correcting broken processes of life.
Necessary to create peace and isolation, appointed a special diet, in case of a serious condition - artificial intravenous nutrition.
It is important to removal of the primary focus of infection, the use of two or more antibiotics sometimes in combination with hormones.
If necessary, the patient produces an infusion of blood plasma, gamma globulin and glucose.
In forming the secondary septic foci need of surgical treatment - opening of abscesses, pus, removal and washing of wounds, excision of lesions.
Forecast
In spite of all the measures, the prognosis in sepsis, severe - mortality rate reaches 60%, disability after suffering sepsis is also quite high.
