Septic shock

Alternative names

Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Definition

Septic shock is a serious, abnormal condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. Vital organs, such as the brain, heart, kidneys, and liver may not function properly or may fail. Decreased urine output from kidney failure may be one symptom.

Causes, incidence, and risk factors

Septic shock occurs most often in the very old and the very young. It also occurs in people with underlying illnesses. Any bacterial organism can cause septic shock. Fungi and (rarely) viruses may also cause this condition. Toxins released by the bacteria or fungus may cause direct tissue damage, and may lead to low blood pressure and poor organ function. These toxins also produce a vigorous inflammatory response from the body which contributes to septic shock.

Risk factors include: underlying illnesses, such as diabetes; hematologic cancers (lymphoma or leukemia) and other malignancies; and diseases of the genitourinary system, biliary system, or intestinal system. Other risk factors are recent infection, prolonged antibiotic therapy, and having had a recent surgical or medical procedure. See also:

• Meningococcemia
  
• Waterhouse-Friderichsen syndrome
  
• DIC (disseminated intravascular coagulation)
  
• Multiple organ dysfunction syndrome (MODS)
  
• ARDS
  

Symptoms

• High or very low temperature, chills
  
• Lightheadedness
  
• Shortness of breath
  
• Palpitations
  
• Cool, pale extremities
  
• Restlessness, agitation, lethargy, or confusion
  

Some physical findings may be easily detected:

• Rapid heart rate
  
• Low blood pressure, especially when standing
  
• Low urine output
  

Signs and tests

• Blood gases revealing low oxygen concentration and acidosis
  
• Blood cultures or blood count detecting infection
  
• Low blood pressure