pyemia

Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.

Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Bacterial infections are the most common cause, but other types of infections can also cause it.

The infections are often in the lungs, stomach, kidneys, or bladder. It's possible for sepsis to begin with a small cut that gets infected or with an infection that develops after surgery. Sometimes, sepsis can occur in people who didn't even know that they had an infection.

Anyone with an infection could get sepsis. But certain people are more likely to develop it:

• Adults 65 or older
• People with chronic (long-lasting) conditions, such as diabetes, lung disease, cancer, and kidney disease
• People with weakened immune systems
• Pregnant women
• Children younger than one

Sepsis can cause one or more of these symptoms:

• Rapid breathing and heart rate
• Shortness of breath
• Confusion or disorientation
• Extreme pain or discomfort
• Fever, shivering, or feeling very cold
• Clammy or sweaty skin

It's important to get medical care right away if you think you might have sepsis or if your infection is not getting better or is getting worse.

Severe cases of sepsis can lead to septic shock, where your blood pressure drops to a dangerous level and multiple organs can fail.

To find out if you have sepsis, your health care provider:

• Will take your medical history, which includes asking about your symptoms
• Will do a physical exam, which includes checking vital signs (your temperature, blood pressure, heart rate, and breathing)
• Will likely order lab tests that check for signs of infection or organ damage
• May order imaging tests such as an x-ray or a CT scan to find the location of the infection

Many of the signs and symptoms of sepsis can also be caused by other medical conditions. This may make sepsis hard to diagnose in its early stages.

It is very important to get treatment right away. Treatment usually includes:

• Antibiotics.
• Maintaining blood flow to organs. This may involve getting oxygen and intravenous (IV) fluids.
• Treating the source of the infection.
• If needed, medicines to increase blood pressure.

In serious cases, you might need kidney dialysis or a breathing tube. Some people need surgery to remove tissue damaged by the infection.

To prevent sepsis, you should try to prevent getting an infection:

• Take good care of any chronic health conditions that you have
• Get recommended vaccines
• Practice good hygiene, such as handwashing
• Keep cuts clean and covered until healed

NIH: National Institute of General Medical SciencesCenters for Disease Control and Prevention

Bacteria are tiny organisms (living things) that have only one cell. Under a microscope, they look like balls, rods, or spirals. They can be found almost everywhere on Earth. There are lots of bacteria in and on your body. In fact, your body has about 10 times more bacteria cells than human cells.

There are many different types of bacteria. Most types don't make you sick. Some types are helpful. For example, "good" bacteria in your digestive system can help your body digest food and absorb vitamins and minerals. They can help protect you from getting sick. Bacteria are also used in making foods like yogurt and cheese.

But some types of bacteria can cause an infection and make you sick. They are called infectious bacteria. These bacteria can reproduce quickly in your body. Many of them give off toxins (poisons) that can damage your cells and make you sick. Other types can move into and damage your tissues. A few examples of bacteria that cause infections include Streptococcus, Staphylococcus, and E. coli.

There are different ways that bacterial infections may spread:

• Through droplets and particles that are breathed out by someone who has the infection. You might breathe in the droplets or particles, or they could land on your mouth, nose, or eyes.
• By touching surfaces or objects that have the bacteria on them and then touching your mouth, nose, or eyes.
• Through cuts, scrapes, and skin-to-skin contact with someone who has the infection.
• From the pregnant parent to the baby during pregnancy.
• Through contaminated food or water.
• By being bitten by an infected insect or animal.
• Through sexual contact (usually vaginal, anal and oral sex) with someone who has the infection.

Sometimes your immune system may be able to fight off a bacterial infection. But when you do need treatment, it will be with antibiotics.

You can help prevent some bacterial infections by:

• Getting vaccines that protect against bacterial infections.
• Having good hygiene habits. These include washing your hands often and covering your mouth and nose when coughing or sneezing.
• Paying attention to food safety.
• Cleaning and disinfecting surfaces that your frequently touch.
• Preventing insect bites by using a U.S. Environmental Protection Agency (EPA)-registered insect repellent. when you go outdoors. If you travel to an area that has a high risk of diseases from insect bites, also wear long pants, shirts, and socks.
• Practicing safe sex. This means using a latex condom every time you have anal, vaginal, or oral sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
• Avoiding close contact with people who are sick.

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

• Preterm (premature) labor, when your labor starts before 37 completed weeks of pregnancy
• Premature rupture of membranes (PROM), when your water breaks too early. If labor does not start soon afterwards, this can raise the risk of infection.
• Problems with the placenta, such as the placenta covering the cervix, separating from the uterus before birth, or being attached too firmly to the uterus
• Labor that does not progress, meaning that labor is stalled. This can happen when
  • Your contractions weaken
  • Your cervix does not dilate (open) enough or is taking too long to dilate
  • The baby is not in the right position
  • The baby is too big or your pelvis is too small for the baby to move through the birth canal
• Abnormal heart rate of the baby. Often, an abnormal heart rate is not a problem. But if the heart rate gets very fast or very slow, it can be a sign that your baby is not getting enough oxygen or that there are other problems.
• Problems with the umbilical cord, such as the cord getting caught on the baby's arm, leg, or neck. It's also a problem if cord comes out before the baby does.
• Problems with the position of the baby, such as breech, in which the baby is going to come out feet first
• Shoulder dystocia, when the baby's head comes out, but the shoulder gets stuck
• Perinatal asphyxia, which happens when the baby does not get enough oxygen in the uterus, during labor or delivery, or just after birth
• Perineal tears, tearing of your vagina and the surrounding tissues
• Excessive bleeding, which can happen when the delivery causes tears to the uterus or if you are not able to deliver the placenta after you give birth to the baby
• Post-term pregnancy, when your pregnancy lasts more than 42 weeks

If you have problems in childbirth, your health care provider may need to give you medicines to induce or speed up labor, use tools to help guide the baby out of the birth canal, or deliver the baby by Cesarean section.

NIH: National Institute of Child Health and Human Development

Critical care is medical care for people who have life-threatening injuries and illnesses. It usually takes place in an intensive care unit (ICU). A team of specially-trained health care providers gives you 24-hour care. This includes using machines to constantly monitor your vital signs. It also usually involves giving you specialized treatments.

You need critical care if you have a life-threatening illness or injury, such as:

• Severe burns
• COVID-19
• Heart attack
• Heart failure
• Kidney failure
• People recovering from certain major surgeries
• Respiratory failure
• Sepsis
• Severe bleeding
• Serious infections
• Serious injuries, such as from car crashes, falls, and shootings
• Shock
• Stroke

In a critical care unit, health care providers use lots of different equipment, including:

• Catheters, flexible tubes used to get fluids into the body or to drain fluids from the body
• Dialysis machines ("artificial kidneys") for people with kidney failure
• Feeding tubes, which give you nutritional support
• Intravenous (IV) tubes to give you fluids and medicines
• Machines which check your vital signs and display them on monitors
• Oxygen therapy to give you extra oxygen to breathe in
• Tracheostomy tubes, which are breathing tubes. The tube is placed in a surgically made hole that goes through the front of the neck and into the windpipe.
• Ventilators (breathing machines), which move air in and out of your lungs. This is for people who have respiratory failure.

These machines can help keep you alive, but many of them can also raise your risk of infection.

Sometimes people in a critical care unit are not able to communicate. It's important that you have an advance directive in place. This can help your health care providers and family members make important decisions, including end-of-life decisions, if you are not able to make them.

Endocarditis is sometimes called infective endocarditis. It's a rare but life-threatening inflammation of the lining inside your heart's chambers and valves (the endocardium).

Endocarditis is usually caused by germs that get into your bloodstream and travel to your heart. Once they get inside your heart, the germs can attach to the lining or get trapped in the valves. They start to grow, causing an infection. If not treated quickly, the infection can cause damage to the heart and lead to serious health problems.

Bacterial infections cause most endocarditis. Normally, many bacteria live in your mouth, on your skin, or in other parts of the body. Sometimes the bacteria can get into your bloodstream from injuries such cuts or scrapes. Dental work and certain surgeries can also allow small amounts of bacteria to enter your bloodstream.

In some cases, fungal infections cause endocarditis. The fungi, such as yeast, can live in parts of your body. Fungal infections generally happen in people who have weakened immune systems that can't stop the fungus from growing. This includes people who have HIV.

In general, endocarditis is rare. If you're healthy, your immune system usually destroys the germs in your bloodstream before they can cause harm.

But your chance of developing endocarditis may be higher than most people if you:

• Have certain heart conditions. Damaged or abnormal heart tissue and devices in your heart can trap germs more easily than healthy heart tissue. That means your risk of endocarditis is higher if you have:
  • Heart valve disease.
  • Certain congenital heart defects.
  • A pacemaker or an implantable defibrillator.
  • A heart valve replacement.
• Are older. Age-related changes to the heart valves, such as mitral valve prolapse or calcium deposits in the aortic valve, create places for germs to attach to the heart.
• Inject illegal drugs. Unclean needles may carry bacteria into the bloodstream.
• Have a condition that weakens your immune system.
• Don't take care of your teeth and gums. Poor dental health makes it easier for germs to get into your bloodstream through your gums and mouth.
• Have a long-term central venous line, a tube that stays in a large vein for weeks or months for medical treatment.
• Have already had endocarditis. Endocarditis can damage heart tissue, which increases your risk of getting it again.

Endocarditis symptoms may be severe or very mild. They may start suddenly or slowly. And they can vary from person to person. The possible symptoms of endocarditis include:

• Fever and chills
• New or worsening heart murmur (an unusual sound heard between heartbeats)
• Chest pain
• Cough
• Muscle, joint, and back pain
• Night sweats (heavy sweating during sleep)
• Shortness of breath (feeling like you can't get enough air)
• Skin changes, including:
  • Broken blood vessels
  • Painful red or purple bumps
  • Painless flat red spots on the palms of your hands or soles of your feet

When the germs are in your heart, they can clump together with blood cells. These clumps can break off and travel through your bloodstream. They may block blood flow, spread infection, or damage your organs, including your brain, lungs, kidneys, and spleen.

Endocarditis may sometimes lead to sepsis, a medical emergency that happens when your body has an extreme response to the infection.

Endocarditis can also cause serious heart problems including:

• Heart valve damage
• Heart failure
• Arrhythmia (a problem with the rate or rhythm of your heartbeat)

To find out if you have endocarditis, your health care provider will:

• Ask about your medical history, including your symptoms, recent illnesses, and other health conditions that affect your chance of developing endocarditis.
• Do a physical exam.
• Likely order tests, such as:
  • Blood tests to check for signs of infection, bacteria, or fungi in your blood.
  • Chest x-rays.
  • Heart tests.

If you have endocarditis, it's important to get treatment quickly. Treatments may include:

• Medicines:
  • Antibiotics to treat bacterial infections. Antibiotics are usually started through an intravenous (IV) line in the hospital.
  • Antifungal medicine to treat fungal infections. Your provider may suggest taking antifungal medicine for the rest of your life to prevent the infection from coming back.
• Heart surgery may be needed to repair or replace damaged valves and heart tissue. Surgery may also be done to remove infected tissue.
• Dental care, especially cleanings, can help reduce the amount of bacteria that grows in your mouth.

Treatment may last weeks, and you may need tests to make sure it's working. Your provider will also check you for problems that could develop from endocarditis, such as heart failure or an irregular heartbeat.

If you have a higher chance of developing endocarditis than most people, you can reduce your risk if you:

• Take good care of your teeth and gums every day
• Have dental exams and cleaning at your dentist's office every 6 months
• Make heart-healthy habits part of your daily life to help prevent heart disease
• Call your health care provider right away if you have symptoms that could be endocarditis

People with the highest risk for bacterial endocarditis need antibiotics before dental visits or certain medical or surgical procedures. Ask your provider if you're part of the highest risk group. If so, let all your providers know about your risk.

NIH: National Heart, Lung, and Blood Institute

During pregnancy, some common infections like the common cold or a skin infection do not usually cause serious problems. But other infections can be dangerous to you, your baby, or both. Some infections may lead to preterm birth and low birth weight babies. Others can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems.

Some of the infections that can be dangerous during pregnancy include:

• Bacterial vaginosis (BV)
• Group B strep (GBS)
• Hepatitis
• Sexually transmitted infections (STIs)
• Toxoplasmosis
• Urinary tract infections
• Yeast infections
• Zika virus

To try to prevent infections:

• Don't eat raw or undercooked meat.
• Don't share food or drinks with other people.
• Wash your hands frequently.
• Don't empty cat litter. Cats can transmit toxoplasmosis.
• Talk to your health care provider about vaccinations.
• If you have sex during pregnancy, use a condom every time.

If you do get an infection during pregnancy, contact your health care provider about how best to protect you and your baby. Only some medicines are safe during pregnancy.

Legionnaires' disease is a serious type of pneumonia caused by Legionella bacteria. The disease got its name when a group of people at an American Legion convention became ill with this type of pneumonia.

Legionella is found naturally in freshwater, such as lakes and rivers. It can also be found in soil. But people usually only get sick from it when if it grows and spreads in man-made water systems. These systems can include hot tubs, fountains, and the plumbing systems of large buildings, such as hotels or nursing homes.

Legionella can also cause Pontiac fever. This is a milder, flu-like illness that doesn't infect your lungs.

You usually can't get infected by drinking water that contains the bacteria unless you aspirate it (accidentally breathe the water into your lungs). The bacteria don't spread from person to person. Disease outbreaks happen when many people are exposed to the same water source that contains the bacteria.

Most healthy people who come in contact with the bacteria do not become sick. You are more likely to develop an infection if you:

• Are over the age of 50
• Are a current or former smoker
• Have a chronic (long-lasting) disease such as diabetes or kidney failure
• Have a chronic lung disease such as COPD or emphysema
• Have a weakened immune system due to a disease such as HIV or cancer or are taking medicines that suppress your immune system
• Live in a long-term care facility
• Have recently stayed in a hospital or had surgery requiring anesthesia

The symptoms usually show up 2 to 14 days after you were exposed to Legionella bacteria. Most of the symptoms are similar to those of other types of pneumonia. But Legionnaires' disease may also cause gastrointestinal symptoms and mental changes.

The symptoms of Legionnaires' disease may include:

• Cough
• High fever
• Chills
• Headache
• Chest pain
• Shortness of breath
• Fatigue
• Nausea and vomiting
• Diarrhea
• Confusion

Legionnaires' disease can cause life-threatening complications such as respiratory failure, kidney failure, and sepsis.

About 1 out of every 10 people who get sick with Legionnaires' disease will die from complications of the illness.

To find out if you have Legionnaires' disease, your health care provider will probably order a chest x-ray to see if you have pneumonia. If you do have it, lab tests such as a urine or sputum test can check for the Legionella bacteria. Your provider may also order a blood test to see if you have been exposed to the bacteria.

If you have Legionnaires' disease, you will likely need care in a hospital. The treatment is with antibiotics. Most people will recover, especially if they were healthy when they got the disease. Getting treatment early can increase the chances of getting better.

You can lower your risk of getting Legionnaires' disease if you:

• Clean all your water-related devices regularly. This could include portable humidifiers, water heaters, air conditioners, and nasal rinses.
• If you haven't used your faucets and showerheads for a week or more, flush them by letting the hot and cold faucets run for at least two minutes before use.
• Avoid exposure to water sources such as decorative foundations or hot tubs if you don't know how well they are maintained.
• Use windshield cleaner in your wiper fluid tank in your car instead of water.
• Ask about how well your buildings' water systems are maintained.

Centers for Disease Control and Prevention

Meningococcal disease is the name for any illness that is caused by Neisseria meningitidis bacteria (also called meningococcal bacteria). These illnesses are often severe and can sometimes be deadly. They include infections of the lining of the brain and spinal cord (meningitis) and in the bloodstream (sepsis). Vaccines can help prevent the disease.

Some people have Neisseria meningitidis, the bacteria that cause the disease, in the back of their nose and throat. They usually have the bacteria but don't get sick. This is called being a "carrier." But sometimes the bacteria can spread to other parts of the body and cause meningococcal disease.

The bacteria can spread from person to person through saliva (spit). It usually happens through close or lengthy contact with a person who has it. Close contact can include things like kissing and coughing.

You cannot catch the bacteria through casual contact with someone who has the disease. For example, you cannot get it by breathing air where that person has been.

Anyone can get meningococcal disease, but you are more likely to get it if someone you live with has it. You are also more likely to get it if you have direct contact with the saliva of someone who has it (like through kissing).

Also, certain groups of people are more likely to get the disease. They include:

• Children younger than 1 year old.
• Teens and young adults ages 16 through 23 years old.
• Adults 65 years and older.
• People with medical conditions that weaken their immune system, including those with HIV and certain rare immune system diseases.
• People who either don't have a spleen or have a spleen that does not function well.
• People who take complement inhibitor. These are immunotherapy medicines that are given to people with certain rare conditions.
• People who live in crowded settings, such as college dorms or military barracks.
• People who travel to areas where the disease is more common, such as certain parts of sub-Saharan Africa.

There are different types of meningococcal disease. The most common types are meningitis and septicemia. Both types are very serious and can be deadly in a matter of hours.

Meningococcal meningitis is a meningococcal infection of the lining of the brain and spinal cord. The most common symptoms include:

• Fever
• Headache
• Stiff neck

It can also cause symptoms such as:

• Nausea and vomiting
• Photophobia (your eyes being more sensitive to light)
• Confusion

It may be hard to notice these symptoms in newborns and babies. They can also have different symptoms. They may:

• Be slow or inactive
• Be irritable
• Vomit
• Feed poorly
• Have a bulging of the soft spot of their skull

Meningococcal septicemia is a meningococcal infection of the bloodstream. It's also called meningococcemia. When someone has this disease, the bacteria enter the bloodstream and multiply. This damages the walls of the blood vessels and causes bleeding into the skin and organs. The symptoms may include:

• Fever and chills
• Fatigue
• Vomiting
• Cold hands and feet
• Severe aches or pain in the muscles, joints, chest, or abdomen (belly)
• Rapid breathing
• Diarrhea
• A dark purple rash (in the later stages of the disease)

Because it is so serious, you need to seek immediate medical attention if you or your child develops the symptoms of meningococcal disease.

The signs and symptoms of meningococcal disease are often similar to those of other illnesses. This can make it hard to diagnose.

If your (or your child's) health care provider thinks that you or your child could have meningococcal disease, they will order tests that take samples of blood and/or cerebrospinal fluid (fluid near the spinal cord). They will send the samples to a lab for testing. The testing will include bacteria culture testing, which can identify the specific type of bacteria that is causing the infection. Knowing this can help the provider decide on the best treatment.

Certain antibiotics can treat meningococcal disease. It is important that treatment is started as soon as possible. So if the provider thinks you have meningococcal disease, they will give you antibiotics right away (before the test results come back).

People with serious disease may need additional treatments, such as:

• Breathing support
• Medicines to treat low blood pressure
• Surgery to remove dead tissue
• Wound care for parts of the body with damaged skin

Some people with meningococcal disease will have long-term health problems and disabilities. These may include:

• Loss of limb(s)
• Deafness
• Nervous system problems
• Brain damage

Even with treatment, 10 to 15 in 100 people will die from the disease.

The best way to prevent meningococcal disease is to get vaccinated. The U.S. Centers for Disease Control and Prevention (CDC) recommends meningococcal vaccination for:

• All preteens and teens
• Children at higher risk for meningococcal disease
• Adults at higher risk for meningococcal disease

If you are a close contact of a person with meningococcal disease, you will likely be given antibiotics to prevent you from getting sick. This is called "prophylaxis." Close contacts include people who are living together. They also include people who had direct contact with the saliva of a person who has the disease (such as from kissing).

Although it's rare, you can get meningococcal disease more than once.

Centers for Disease Control and Prevention

Pneumococci are a type of streptococcus bacteria. The bacteria spread through contact with people who are ill or by healthy people who carry the bacteria in the back of their nose. Pneumococcal infections can be mild or severe. The most common types of infections are:

• Ear infections
• Sinus infections
• Pneumonia
• Sepsis
• Meningitis

How the diagnosis is made depends upon where the infection is. Your doctor will do a physical exam and ask about your medical history. Possible tests may include blood, imaging, or lab tests. Treatment is with antibiotics. Vaccines can prevent pneumococcal infections. There are two vaccines. One is for infants and young children. The other is for people at high risk, including those who are over 65 years old, have chronic illnesses or weak immune systems, smoke, have asthma, or live in long-term care facilities.

Centers for Disease Control and Prevention

Prenatal testing provides information about your baby's health before he or she is born. Some routine tests during pregnancy also check on your health. At your first prenatal visit, your health care provider will test for a number of things, including problems with your blood, signs of infections, and whether you are immune to rubella (German measles) and chickenpox.

Throughout your pregnancy, your health care provider may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:

• Age
• Personal or family medical history
• Ethnic background
• Results of routine tests

There are two types of tests:

• Screening tests are tests that are done to see if you or your baby might have certain problems. They evaluate risk, but do not diagnose problems. If your screening test result is abnormal, it does not mean that there is a problem. It means that more information is needed. Your health care provider can explain what the test results mean and possible next steps. You may need diagnostic testing.
• Diagnostic tests show whether or not you or your baby have a certain problem.

It is your choice whether or not to get the prenatal tests. You and your health care provider can discuss the risks and benefits of the tests, and what kind of information the tests can give you. Then you can decide which ones are right for you.

Dept. of Health and Human Services Office on Women's Health