What are the symptoms of sepsis (Systemic Inflammatory Response Syndrome)?

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From the Guidelines

Sepsis symptoms include fever, low body temperature, rapid heart rate, rapid breathing, confusion, and low blood pressure, and early signs may be subtle, such as feeling unusually tired, experiencing pain, shortness of breath, clammy skin, or decreased urination. According to the Surviving Sepsis Campaign guidelines 1, diagnostic criteria for sepsis include infection, documented or suspected, and some of the following: general variables such as fever, hypothermia, heart rate, tachypnea, altered mental status, significant edema, or hyperglycemia.

Key Symptoms

  • Fever or low body temperature
  • Rapid heart rate
  • Rapid breathing
  • Confusion
  • Low blood pressure
  • Early signs may be subtle, such as feeling unusually tired, experiencing pain, shortness of breath, clammy skin, or decreased urination As sepsis progresses, patients may develop mottled skin, extreme weakness, and organ dysfunction. These symptoms occur because sepsis is a life-threatening condition where the body's response to infection damages its own tissues and organs. The inflammatory response becomes dysregulated, leading to widespread inflammation, blood clotting issues, and potential organ failure. Sepsis requires immediate medical attention, as early treatment with antibiotics and fluids significantly improves survival rates 1. Anyone experiencing a combination of these symptoms, especially after an infection or with risk factors like weakened immunity, should seek emergency care immediately. Sepsis can rapidly progress to septic shock, which has a high mortality rate if not treated promptly.

Importance of Early Treatment

  • Early treatment with antibiotics and fluids significantly improves survival rates
  • Sepsis requires immediate medical attention
  • Sepsis can rapidly progress to septic shock, which has a high mortality rate if not treated promptly It is essential to recognize the symptoms of sepsis and seek medical attention immediately to prevent progression to septic shock and improve outcomes.

From the Research

Symptoms of Sepsis

  • Sepsis is a clinical syndrome that results from the dysregulated inflammatory response to infection that leads to organ dysfunction 2
  • The sepsis state is due to dysregulated host response to infection, leading to inflammatory damage to nearly every organ system 3
  • Sepsis can be life threatening and is often difficult to identify due to subtle signs and symptoms, including cold or clammy skin and changes in the patient's behaviour such as new confusion 4
  • Assessment tools can be used to assess risk of sepsis and include considering a source of infection along with a NEWS 2 or qSOFA score 4

Diagnosis and Management

  • Early recognition of sepsis and appropriate treatment with antibiotics, fluids, and vasopressors is essential to reducing organ system injury and mortality 3
  • Current established treatments include appropriate antimicrobial agents to target the underlying infection, optimization of intravascular volume to improve stroke volume, vasopressors to counteract vasoplegic shock, and high-quality supportive care 2
  • Within 1 hour from diagnosis supportive treatments need to be administered, including the most appropriate antibiotic for the source of infection, fluid and oxygen 4
  • Blood cultures, bloods including lactate and urine measurement are all needed to support management of the patient 4

Treatment Outcomes

  • The use of meropenem versus piperacillin-tazobactam in critically ill patients with sepsis and septic shock has been studied, with meropenem having a lower mortality rate on ventilator-free days, vasopressor-free days, and hospital-free days 5
  • Piperacillin-tazobactam dose reduction in early phase septic shock is associated with worsened clinical outcomes, including lower rates of 28-day norepinephrine-free days and higher rates of in-hospital mortality/hospice disposition 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Sepsis: Current Definition, Pathophysiology, Diagnosis, and Management.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2017

Research

Understanding sepsis.

British journal of nursing (Mark Allen Publishing), 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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