A day after his wife's funeral, former president George H.W. Bush was admitted to the hospital for an infection that spread through his system. Doctors were quick to put him on a regimen of broad spectrum antibiotics which he has so far responded well to.
So, what is sepsis? Sepsis is broadly defined as, “the presence in tissues of harmful bacteria and their toxins, typically through infection of a wound.” In the case of the former president, the tissue in question is his blood which is the most common form of sepsis. More important than the mere presence of foreign bacteria and their associated toxins in the blood or tissue is your body's reaction to it, or overreaction more specifically. Sepsis occurs when your body tries to fight the infection, can't, and then tries even harder which results in it attacking your body instead.
“Sepsis is a term that's been with us for a long, long time and sepsis can describe anything from having a sore throat or an ear infection because you are septic. You have a bacteria that's not where it should be. You have white cells that are trying to fight that bacteria, to somebody who is overwhelmingly septic. And everybody has seen on TV people with septic shock, people who have lost limbs to septic shock or MRSA infections, or staph infections, but it's that whole gamut of infections,” says Dr. Louis M. Guzzi, Director of Critical Care Medicine at Florida Hospital Waterman.
It was previously believed that sepsis was a form of blood poisoning caused by bacteria but we now know that it's actually your body's reaction, or overreaction, to the bacteria. “Most of the bacteria that you and I get would be internal or are on our skin already. I probably already have the staph on my skin that I've got the infection from. What happens most commonly is your immune system is just not good for whatever reason: aging, some drugs you may have taken, nutritional status. Most people get infected by what they already have, what's on their skin,” Dr. Guzzi explains.
It's really no different than the normal reaction your body has to a cut or a scratch but it essentially just tries too hard to heal you and ends up hurting you instead. “Sepsis is a broad representation of an infection that's caused by a bacteria or a virus that is leading you to have the septic manifestations: hypotension, decreased urine output, decreased menostasis, acidosis, respiratory insufficiency, a whole bunch of things that can come with sepsis. It's not a specifically defined end point. Tonsillitis can be sepsis. Pneumonia can be sepsis,” says Dr. Guzzi. Sepsis can cause significant damage to your major organs like the lungs, kidneys, liver, and your blood, as well. Sepsis is responsible for hundreds of thousands of deaths in the US, every year. In fact, a third of all patients who die in the hospital have sepsis.
“First of all, the sooner you seek treatment, the better off you’re going to be. There's a point where you can become so septic or no matter whether you seek treatment or not, we can do nothing to fix you. And sepsis comes in various flavors. Little kids with a sore throat, a strep throat, by definition they're septic. Somebody with a sinusitis, by definition he's septic. He needs antibiotics to help him get better. Everybody talks about somebody with walking pneumonia. That's sepsis as well,” Dr. Guzzi went on to explain.
Very young and very old patients are most at risk and at 93, Mr. Bush falls into a common age range susceptible to the condition. Most sepsis in elderly patients comes from infections from the urinary tract or lungs such as pneumonia. For a proper treatment plan doctors must treat the underlying infection and tailor their care to the patient's individual needs. Knowing which specific bacteria or fungi is responsible for the primary infection is the first step to creating an effective plan of care.
Dr. Guzzi recommends, “If you think your loved one or family member is septic, the first answer is to get them to the hospital. Get them to the emergent department or your primary care doctor very quick and as soon as you can. If it's the middle of the night, obviously the ER. If it's during the day maybe you can call your primary and get them seen.”