Septic Shock: Causes, Symptoms & Treatment (2023)


Septic Shock: Causes, Symptoms & Treatment (1)

What is septic shock?

Septic shock is a serious medical condition that can occur when an infection in your body causes extremely low blood pressure and organ failure due to sepsis. Septic shock is life-threatening and requires immediate medical treatment. It’s the most severe stage of sepsis.

What’s the difference between septic shock and sepsis?

Septic shock is the last and most dangerous stage of sepsis. Sepsis can be divided into three stages: sepsis, severe sepsis and septic shock.

  • Sepsis: Sepsis is life-threatening. It happens when your immune system overreacts to an infection.
  • Severe sepsis: This is when sepsis causes your organs to malfunction. This is usually because of low blood pressure, a result of inflammation throughout your body.
  • Septic shock: Septic shock is the last stage of sepsis and is defined by extremely low blood pressure, despite lots of IV (intravenous) fluids.

Symptoms and Causes

What are the signs and symptoms of septic shock?

Septic shock is the third stage of sepsis. Early signs of sepsis can include:

  • Fast heart rate.
  • Fever or hypothermia (low body temperature).
  • Shaking or chills.
  • Warm, clammy or sweaty skin.
  • Confusion or disorientation.
  • Hyperventilation (rapid breathing).
  • Shortness of breath.

When sepsis turns to septic shock, you may experience additional symptoms. These include:

  • Very low blood pressure.
  • Lightheadedness.
  • Little or no urine output.
  • Heart palpitations.
  • Cool and pale limbs.
  • Skin rash.

What causes septic shock?

Any infection can lead to sepsis which can then develop into septic shock if it worsens. Not every infection will lead to sepsis or septic shock. But, if an infection causes enough inflammation, it can develop into sepsis. Most of the common infections are from bacteria, but both viruses and fungi can also cause infections and sepsis. Infections can start anywhere but commonly begin in your lungs, bladder or stomach.

What are the risk factors for septic shock?

Your septic shock risk increases if you have a weakened immune system which increases your risk for sepsis. People with weakened immune systems include:

(Video) Sepsis and Septic Shock, Animation.

  • Newborns.
  • Those over age 65.
  • People who are pregnant.
  • People who use recreational drugs.
  • People with artificial joints or heart valves.

People with chronic medical conditions have an increased risk of sepsis. These conditions include:

  • AIDS.
  • Diabetes.
  • Leukemia or lymphoma.
  • Immune disorders.

In addition, people who’ve had recent infections, surgeries, transplants or medical devices implanted have an increased risk of sepsis.

What are the complications of septic shock?

Septic shock is a very serious medical condition. It’s the most severe stage of sepsis. Septic shock can lead to:

  • Brain damage.
  • Lung failure.
  • Heart failure.
  • Kidney failure.
  • Gangrene.
  • Death.

Diagnosis and Tests

What tests will be done to diagnose septic shock?

Your healthcare provider may suspect sepsis if you’ve had an infection and you suddenly develop a fever or hypothermia, rapid heart rate or breathing rate, or low blood pressure.

Your healthcare provider may run blood tests to check for:

  • Presence of bacteria and/or infection.
  • Complete blood count.
  • Blood chemistries, including lactate.
  • Blood oxygen levels.
  • Organ malfunction.

Your healthcare provider may also collect samples of your urine, saliva, tissues and/or cerebrospinal fluid for further tests.

In addition, you may have imaging tests to find the source of infection. These imaging tests include:

(Video) Sepsis: Everything You Need to Know

  • Chest X-ray.
  • Computed tomography (CT) scan.
  • Magnetic resonance imaging (MRI) scan.

Management and Treatment

How is septic shock treated?

If you have septic shock, you need immediate treatment. Treatment is usually in an intensive care unit (ICU).

Your healthcare provider will start you on antibiotics immediately. They will also give you fluids through your vein (intravenously) to rehydrate you and help increase your blood pressure.

You may receive oxygen through a face mask or a nasal cannula, a small plastic tube with two openings for your nostrils. A breathing tube may be placed in your windpipe (trachea) to connect you to a breathing machine (ventilator) if you can’t breathe well on your own.

In addition, you may need surgery to remove the source of the infection. Abscesses may be drained. Dead or infected tissue may be removed. Catheters, tubes and medical devices may be removed or changed.

If fluids don’t increase your blood pressure, you may receive medication to raise it. Medications such as vasopressin (Pitressin®) or norepinephrine (Levophed®) cause your blood vessels to narrow and increase the blood flow to your organs.

You may receive insulin if the septic shock has increased your blood sugar (glucose) levels.

If fluids and medication haven’t helped increase your blood pressure, you may receive corticosteroids.

(Video) Septic Shock: Treating Blood Infections, Pneumonia, Urinary Tract Infections


How can I prevent septic shock?

If you have a bacterial infection, receive treatment right away. Antibiotics can help with the infection and prevent sepsis from occurring, which can lead to septic shock.

It’s also important to keep up to date on your vaccines. Vaccines can help prevent some infections, and they greatly lessen the severity of others. Keep in mind, some cases of septic shock can’t be prevented.

Outlook / Prognosis

What is the survival rate of septic shock?

Septic shock is a severe, life-threatening condition. The survival rate is low. Survival depends on your age, health, cause of the condition, if you’ve had organ failure and how quickly you receive treatment. Without treatment, most people will die of septic shock. With treatment, 30% to 40% of people with septic shock die.

What is recovery like after septic shock?

Many people recover from septic shock, but it can take a long time. You may continue to have symptoms for months or years. These long-term effects are called post-sepsis syndrome. These effects can include:

  • Fatigue.
  • Difficulty sleeping.
  • Lack of appetite.
  • Weakened immune system.
  • Mood disorders, anxiety or depression.
  • Nightmares or flashbacks.

To help with your recovery, make sure you:

  • See your healthcare provider regularly.
  • Eat a healthy diet.
  • Get regular exercise.
  • Get enough sleep.
  • Avoid infections.

Living With

When should I go to ER?

If you develop any symptoms of sepsis or septic shock, you should call 911 or go to the emergency room (ER) immediately.

(Video) Sepsis: The Body’s Deadly Response to Infection

Frequently Asked Questions

Can you survive septic shock?

Septic shock is a severe medical condition. The survival rate is low, but people do survive. Survival depends on your age, health, cause of the condition, if you’ve had organ failure and how quickly you receive treatment. Without treatment, most people die of septic shock. With treatment, 30% to 40% of people with septic shock die.

What is the most common cause of septic shock?

Sepsis causes septic shock. Bacterial infections are the most common cause of sepsis. The source of the infection can be anywhere in your body. Most often, the infection will start in your lungs, abdomen or urinary tract. In some people, toxins are released by the bacteria and get into your bloodstream. This causes sepsis.

What are the three stages of sepsis?

Sepsis can be divided into three stages. The stages are sepsis, severe sepsis and septic shock:

  • Sepsis: Sepsis is when your immune system overreacts to an infection and starts to attack your body’s tissues and organs.
  • Severe sepsis: When your immune system starts to attack your organs, they don’t receive enough blood, causing them to malfunction. Severe sepsis describes sepsis complicated by organ malfunction.
  • Septic shock: Sepsis also causes low blood pressure. Septic shock describes sepsis complicated by organ failure and blood pressure that remains low despite treatment with fluids.

How do you know if you have septic shock?

Your healthcare provider may suspect sepsis if you’ve had an infection and you suddenly develop a fever or hypothermia, rapid heart rate or breathing rate, or low blood pressure. Your healthcare provider will run additional tests to confirm the diagnosis.

A note from Cleveland Clinic

Septic shock is a severe condition. Be prepared by knowing the signs and symptoms of sepsis and septic shock. If you develop any of the symptoms, call 911 or get to the emergency room ASAP. While septic shock can be a scary diagnosis, immediate treatment is important and could save your life. If you have experienced septic shock, make sure to see your healthcare provider regularly for follow-up visits. They may also be able to provide you with additional resources to help you in your recovery.

(Video) Septic shock: Diagnosis and treatment | Circulatory System and Disease | NCLEX-RN | Khan Academy


What causes septic shock symptoms? ›

Septic shock is a life-threatening condition that happens when your blood pressure drops to a dangerously low level after an infection. Any type of bacteria can cause the infection. Fungi such as candida and viruses can also be a cause, although this is rare. At first the infection can lead to a reaction called sepsis.

Can a person recover from septic shock? ›

Are there any long-term effects of sepsis? Many people who survive sepsis recover completely and their lives return to normal. However, as with some other illnesses requiring intensive medical care, some patients have long-term effects.

What is the first and most important treatment in septic shock? ›

The recommended first-line agent for septic shock is norepinephrine, preferably administered through a central catheter. Norepinephrine has predominant alpha-receptor agonist effects and results in potent peripheral arterial vasoconstriction without significantly increasing heart rate or cardiac output.

What is one of the first signs of sepsis? ›

Early symptoms of sepsis may include:
  • a high temperature (fever) or low body temperature.
  • chills and shivering.
  • a fast heartbeat.
  • fast breathing.
Jan 25, 2023

What are the early warning signs of septic? ›

The signs and symptoms of sepsis can include a combination of any of the following:
  • confusion or disorientation,
  • shortness of breath,
  • high heart rate,
  • fever, or shivering, or feeling very cold,
  • extreme pain or discomfort, and.
  • clammy or sweaty skin.
Aug 31, 2017

What organ shuts down first with sepsis? ›

Sepsis can overwhelm the body. This can cause vital organs to shut down. This usually starts with the kidneys. Blood pressure can drop dangerously low.

What are the 3 stages of septic shock? ›

The three stages of sepsis are: sepsis, severe sepsis, and septic shock. When your immune system goes into overdrive in response to an infection, sepsis may develop as a result.

Does septic shock happen suddenly? ›

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.

How long is a hospital stay with septic shock? ›

A 2018 retrospective analysis of more than 2 million U.S. sepsis hospitalizations reported that the median length of stay (LOS) for sepsis increased with disease severity ranging from 7.7 days, 10 days, and 12.6 days for sepsis, severe sepsis and septic shock, respectively.

How many days can you be in septic shock? ›

Clinically identified cases of septic shock are more likely to pass away within 28 days than undiagnosed cases. Within the first week of diagnosis, sepsis that progresses to severe sepsis or septic shock increases the risk of death.

How long can you have sepsis without knowing? ›

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.

What are two 2 of the most common causes of septic shock? ›

Sepsis can result from a bacterial, fungal, or viral infection. These infections may begin at home or while you're in the hospital for treatment of another condition.

What are the four stages of septic shock? ›

During the treatment of patients with septic shock, four phases of fluid therapy should be considered in order to provide answers to four basic questions. These four phases are the resuscitation phase, the optimization phase, the stabilization phase and the evacuation phase.

What bacteria causes sepsis? ›

Some of the most frequently isolated bacteria in sepsis are Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Klebsiella spp., Escherichia coli (E. coli), and Pseudomonas aeruginosa (P.

What happens right before sepsis? ›

High heart rate or weak pulse. Fever, shivering, or feeling very cold. Confusion or disorientation. Shortness of breath.

Where does sepsis pain start? ›

Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

What is the number one cause of sepsis? ›

Most sepsis is caused by bacterial infections, but it can also be caused by viral infections, such as COVID-19 or influenza; fungal infections; or noninfectious insults, such as traumatic injury.

What are the red flag warning signs for sepsis? ›

Immediate action required: Call 999 or go to A&E if:

An adult or older child has any of these symptoms of sepsis: acting confused, slurred speech or not making sense. blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet.

What is the difference between sepsis and septic shock? ›

Severe sepsis develops when the infection causes organ damage. Septic shock is the most severe form in which the infection causes low blood pressure, resulting in damage to multiple organs.

What are the early vs late signs of septic shock? ›

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.

What are the stages of sepsis before death? ›

Sepsis is classified into three stages, and if a referral to hospice is necessary, it should be made quickly.
  • Sepsis. Sepsis is the initial infection, which sets off an inflammatory immune response that affects the entire body. ...
  • Severe Sepsis. ...
  • Septic Shock.

What are the odds of surviving septic shock? ›

Most people recover from mild sepsis, but the mortality rate for septic shock is about 30% to 40%. Also, an episode of severe sepsis raises the risk for future infections.

What mimics septic shock? ›

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.

What is silent sepsis? ›

Sepsis is known as the 'silent killer' because its symptoms often mimic that of other illnesses such as the flu or gastro. But, if it is identified and treated early, patients can recover.

Can you have sepsis for months? ›

Many people will find recovering from sepsis difficult and can have a number of symptoms develop in the weeks or months after they leave hospital.

How do they test for sepsis? ›

Blood tests may reveal the following signs suggestive of sepsis: Elevated or low white blood cells – Higher than usual levels of leukocytes, known as white blood cells (WBCs), are a sign of a current infection, while too few WBCs indicate that a person is at higher risk of developing one.

Can you get sepsis from a UTI? ›

Untreated urinary tract infections may spread to the kidney, causing more pain and illness. It can also cause sepsis. The term urosepsis describes sepsis caused by a UTI. Sepsis, which was often called blood poisoning, is the body's life-threatening response to infection or injury.


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