Septic shock – Causes, symptoms and treatment

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When shock occurs due to an overwhelming infection resulting in the spread of infection to the entire body, it causes septic shock.

Septic shock – Causes, symptoms and treatmentThe blood vessels are responsible for the spread of infection. It is also called warm shock, septicemic shock or endotoxic shock. In most cases, bacteria cause the infection but rarely, a fungus or virus could cause it.

Causes of septic shock

  1. Systemic diseases like diabetes mellitus increases risk of developing this condition, particularly if the blood sugars are not well controlled.
  2. Diseases affecting the immune system such as cancers like leukemia, HIV and AIDS as well as connective tissue disorders make a person susceptible to sepsis
  3. A serious infection of the gastro-intestinal or urinary system or a serious infection of the lungs or heart may cause septic shock if inadequately treated.
  4. A recent major surgery, taking steroids for a long time or taking antibiotics for long may cause septic shock.
  5. Having catheters in the body for a long time such as those with paralysis like hemiplegia (affecting one side of the body) or paraplegia (affecting both lower limbs) are more likely to develop shock as the catheter if not changed regularly acts as a source of infection.

Symptoms and signs of septic shock

  • High fever or fever with chills
  • Weakness, fatigue
  • Confusion, agitation
  • Cold clammy and pale skin
  • Passing less urine
  • Fast pulse
  • Low blood pressure or hypotension is an important sign
  • Increased breathing rate

Diagnosis of septic shock

It is easy to miss the diagnosis when only few signs are present, but it must be watched out for because it is a medical emergency. The patient must be immediately transferred to an ICU of a well-equipped hospital.

Investigations to diagnose septic shock

All routine blood, urine and stool examinations are done. A chest X- ray and X- ray if any other condition is suspected should be done immediately. Other investigations like USG, CT scan and MRI are done depending on the individual case.

Treatment of septic shock

The first line of treatment is to stabilise the patient and diagnose the cause. If the shock is due to bacteria, a high antibiotic is started intravenously. If it is viral, anti-viral drugs are given and if it is fungal in origin, anti-fungal drugs are administered.

Intravenous fluids are given and drugs to counteract the low blood pressure such as dopamine.

If the patient has trouble breathing, he may be put on a ventilator till stabilised. Alternatively, oxygen can be given by mask.

Ifsurgery is required, it should be done as soon as the patient is fit for surgery.

Complications of septic shock

If the patient is not diagnosed and treated promptly, low blood pressure may cause heart to fail or heart attack to occur.

Pulmonary oedema in which the lungs are filled with fluid is another dangerous complication.

Kidney failure may occur.

Liver damage or damage to the brain or abdominal organs may be there.

Gangrene of some parts of the body may occur due to lack of blood supply and overwhelming infection.

Prognosis

Septic shock is a medical emergency and has a high death rate if medical attention is not given on time.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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