Sepsis( blood poisoning) symptoms
Mar 07, 2018
Sepsis is a severe disease that develops when infects the blood of with pyogenic microbes or their toxins when the immune mechanisms fail. If in this case a large number of microbes are found in the blood, then this condition is called septicemia. If this condition is caused not by septicemia, but by finding in the blood only the products of their vital activity - toxins, then they talk about toxemia. If the general intoxication is accompanied by the formation of purulent foci in various tissues and organs, then this condition is called septicopyemia. Symptoms, course. High temperature with significant fluctuations and chills. Heavy general condition of the patient, frequent pulse of small filling, pronounced general weakness, sometimes pouring perspiration, exhaustion of the patient. In the blood, high leukocytosis with a significant shift of the white formula to the left. Purulent wounds become lethargic, bleed, the pus's compartment decreases, the wound becomes dry.
Prevention of .Timely and adequate treatment of various acute purulent processes. Early surgical treatment of purulent foci and antibiotics.
Septic shock is a life-threatening condition that results from the ingress of infectious viruses( sepsis) into the blood, usually bacteria. Inflammation as a response of the body to infectious agents or their toxic secretions leads to the production of substances that cause the expansion of blood vessels, a decrease in cardiac output and the infiltration of fluid from small blood vessels into tissues. Blood pressure drops sharply( septic shock), and body cells begin to experience oxygen starvation and die off.
Cell damage can quickly lead to a massive failure of organ systems - the liver, lungs, brain, kidneys and heart. The inadequacy of any of the vital organs can be fatal. Septic shock often occurs in hospitalized patients, especially with serious infectious diseases. Early detection of signs of possible shock and immediate treatment are necessary.
• Bacterial infection is the most common cause of septic shock. Stitched wounds, deep cuts, burns, surgical procedures or the use of a urinary catheter can lead to the ingress of bacteria into the blood.
• Sometimes viral or fungal infections cause a septic shock.
• Risk factors for the development of septic shock and for more serious consequences include other diseases, such as diabetes mellitus, late stage cancer and cirrhosis;severe injury or burns;serious operations;weakened immune system due to AIDS or cancer treatment. Newborns and the elderly are also at higher risk of disease.
It is observed more often in septic miscarriages, especially in later periods, less often with infected labor. It occurs mainly in cases of mass lysis of Gram-negative bacteria( Escherichia coli group, Proteus, Pseudomonas aeruginosa), endotoxin is released upon destruction of the envelope. Less commonly observed with infection caused by staphylococci or streptococci. At the heart of septic shock lie acute disorders of hemodynamics. Often accompanied by a violation of blood clotting. There is a danger of bleeding from hypo- and afibrinogenemii. Hypoxia and acidosis are expressed.
Symptoms, course. The disease begins suddenly with chills and very high fever. There are tachycardia, hyperemia, hypotension. After a few hours the blood pressure drops sharply, the pulse becomes frequent, weak filling. In the diagnosis it is important that the drop in blood pressure is not associated with bleeding. Against this background, acute renal failure may develop, manifested first oliguria( urine is released less than 400 ml per day).There are paresthesia, hypotension, a disorder of the heart activity( rhythm disturbance, brady or tachycardia, cardiac blockade), stuporosis, dyspnea, vomiting. After 5-6 days, diuresis is gradually restored, polyuria occurs.
Treatment. You should urgently call a doctor and immediately start fighting with shock. Intravenously injected plasma or plasma substitutes( polyglucin) 250-500 ml of jet, then up to 2000 ml of drip. When bleeding blood is poured. In the initial stage of shock, antihistamines and vasodilators are shown, with the collapse of norepinephrine, mezaton, hyperthesin, intravenously high doses of prednisolone( 100-200 mg, and 500-1000 mg per day).To prevent intravascular coagulation, 5000-10 000 IU of heparin is injected every 6 hours. Of the antibiotics, kanamycin, ampicillin and penicillin in high doses( up to 10,000,000 units per day).Removal of the fetal egg or uterus is possible only after removal of the patient from the shock state. In acute renal failure, urgent hospitalization in a special department( "Artificial kidney") is indicated.
Sepsis is a disease that is especially prone to newborns. The causative agent can be a variety of microorganisms and their combinations. Recently, Staphylococcus is especially often secreted. Infection is possible in utero, during childbirth and is often extra-utero. The source of infection is a sick mother;staff caring for the child may be the carrier of the infection;Important are contaminated care items, as well as the baby's food and inhaled air. The entrance gates of infection can be skin, mucous membranes, gastrointestinal tract and respiratory tract;The most frequent gateway to infection is the navel. Sepsis has no definite incubation time;with intrauterine infection it can begin on the 1st week of life, in other cases - at the 2nd and even the 3rd week. Two main forms of the disease, septicemia and septicopyemia, are distinguished along the course.
Common initial manifestations of sepsis - deterioration of well-being, sluggish sucking, regurgitation, vomiting, cessation of weight gain or slight weight loss. There may be a high fever, a low subfebrile condition and even a normal temperature. Skin with a grayish tinge.
Septicemia is more common in preterm and debilitated children, more violent, malignant. Often begins with acute intoxication, violations of water and mineral metabolism, with the development of dyspepsia, jaundice, hemorrhagic syndrome, rapid loss of weight. Tachycardia, muffling of cardiac tones, toxic respiration are observed. Sometimes symptoms of nervous system damage prevail( anxiety, frustration, convulsions).There is an increase in the liver, spleen, anemia, leukocytosis, neutrophilia, increased ESR.In the urine can be found leukocytes, red blood cells, cylinders.
Septicopyemia, ie sepsis with metastases, secondary purulent foci, proceeds more benignly, is more often observed in full-term children, with better reactivity of the organism. It begins with the appearance of pustules on the skin, sometimes abscesses develop, furuncles. Possible purulent foci in the pleura, pericardium, in the lungs, as well as purulent otitis, meningitis, etc. With umbilical sepsis in cases where the entrance collar of the infection was the navel, in addition to general phenomena, omphalitis, periarteritis of the umbilical artery and phlebitis of the umbilical vein can be observed.
Treatment of .Careful care, breastfeeding. Immediate administration of broad-spectrum antibiotics, penicillin is used in a daily dose of up to 200,000 U / kg of body weight. It is advisable to administer antibiotics at the lesion site( intrapleural, into the abscess cavity, etc.).In severe cases, a combination of antibiotics with sulfanilamide preparations is shown at a rate of 0.2 g / kg of body weight per day. Carry out stimulating therapy - direct blood transfusion, the introduction of plasma( up to 10 ml / kg of body weight every 3-4 days) and gamma globulin directed( 1.5-3 ml every other day, only 3-5 times).Corticosteroids are prescribed a short course only in the acute period of sepsis with severe general toxic effects( 1 mg / kg body weight per day).Vitamins, enzymes, local treatment of septic foci( medicamentous, surgical, physiotherapeutic) are recommended. The prognosis is favorable with timely and active treatment.
Septicemia is a septic lesion of the whole organism, in which germs, getting into the blood and multiplying in it, are carried throughout the body, causing intoxication of it. When septicopyemia germs, getting with blood flow to different organs, form in them metastatic foci of septic infection, which are usually subjected to suppuration. Symptoms, course. The disease begins on the 2nd-4th day after childbirth by a sharp increase in body temperature, increased heart rate, chills. The general condition of the puerperium is heavy. The tongue is dry, covered, the stomach is moderately swollen. Skin covers are of earthy yellow color, headache, thirst, dry mouth. Uterus flabby, poorly shortened, somewhat sensitive to palpation, significant bloody-ichoric discharge. In the urine protein, in the blood leukocytosis and elevated ESR.In the future, there may be metastatic foci in different organs. Depending on their location in the clinical picture, cardiac abnormalities predominate( myocardial damage, endocardium), respiratory organs( metastatic pneumonia), kidneys( focal nephritis).With the reverse development of the metastatic focus of infection, there is a slight improvement in the overall condition with a decrease in temperature. However, when a new foci occurs, the temperature rises again, chills appear and the symptoms caused by the damage to one or another organ.
Treatment. All medical measures should be carried out against a background of careful care for the patient( rational nutrition, abundant drink, compliance with the purity of the body).The main importance in the treatment of septicemia and septicopyemia are antibiotics prescribed in large doses( at least 6 000 000 units per day) and in different combinations. It is necessary to determine the sensitivity of microflora to antibiotics. Semisynthetic penicillins( methicillin and oxacillin), a combination of oleandomycin with tetracycline, oletetrin, and sigmamicin are effective. From sulfonamides, long-acting drugs( sulfapyridazine, sulfadimethoxin, madribon) are of great importance. It is necessary to simultaneously prescribe antifungal drugs( nystatin, levorin, decamine) in order to avoid candidiasis.
Treatment with antibiotics is combined with the administration of anatoxin, gamma globulin, blood transfusion, polyglucin infusions, hemodezia and the administration of vitamins. Treatment of sepsis is carried out only by a doctor.
Sepsis otogenous( thrombophlebitis of sigmoid sinus) complication of acute and chronic suppurative otitis media. Occurs during the transition of the inflammatory process to the wall of sigmoid, less often transverse venous sinus. As a result of infection, there is a thrombus in the sinus, which later becomes inflamed. The detached parts of a purulent thrombus can be carried by a current of blood into the lungs, joints, muscles, subcutaneous tissue, kidneys, etc.
Symptoms. Leaping temperature with an increase to 40-41 ° C, a tremendous chill and drop to normal with a torrential sweat. Less often sepsis occurs with a constant high temperature( usually in children).Heavy general condition, frequent pulse of weak filling. When a blood test is found, typical for sepsis changes.
Treatment. Operation on the ear with the opening of the sigmoid sinus and removal of the clot. Penicillin injections( 250,000 units 6-8 times a day), streptomycin( 500,000 units twice a day), sulfonamides( 6-10 g / day).In children, respectively, smaller doses. Anticoagulants( heparin, neodicumarin), cardiac agents.
Sepsis rhinogenic - a complication of acute or chronic purulent inflammation of the sinus of the nose.
Symptoms and treatment are the same as in otogenous sepsis( surgery is performed on the paranasal sinuses).