Septicaemia is a bacterial infection of the blood, more commonly known as blood poisoning and is defined as the presence of many bacteria actively dividing in the blood. Septicaemia often leads to sepsis which affects the whole body and isn't limited to just the blood, sepsis can also be caused by viral and fungal infections as well as bacterial infections. It is a state of whole-body inflammation and the presence of a known infection. Septicaemia is further complicated by circulatory collapse, myocardial depression (this is cardiac dysfunction where the ventricles of the heart become dilated and there is reduced ejection of blood from the heart), increased metabolic rate, and vasoregulatory perfusion abnormalities (this is the control of nutritive delivery of arterial blood to capillary beds in the body's tissues).
Symptoms of Septicaemia:
PRESSURE SORES STAGES
* High fever
* Violent shivering
* Faintness
* Cold, pale hands and feet
* Loss of consciousness
* Rapid, shallow breathing
* Restlessness
* Delirium
* Shock
Symptoms of Sepsis:
* Abnormal coagulation. Coagulation is the process of blood clotting. In septicaemia altered homeostasis allows the blood to clot when it shouldn't, blocking blood vessels and reducing blood flow.
* Endothelial injury. The endothelium is a thin layer of cells lining the interior of blood and lymphatic vessels, the heart and other body cavities. They reduce friction so that blood can flow more smoothly and more quickly allowing it to be pumped further. The cells are involved in the control of blood pressure, blood clotting, inflammation, the formation of new blood vessels, and they are a selective barrier controlling the passage of materials and the movement of white blood cells in and out of the blood.
* Presence of excessive tumour necrosis factor. Tumour necrosis factor (TNF) is a cytokine (hormones which fight infection) produced mainly by macrophages (a type of white blood cell involved in immune response) involved in systemic inflammation. It regulates immune cells and induces cell death (apoptosis) and inflammation, it inhibits viral replication. High concentrations of TNF induce shock like symptoms while a prolonged exposure to low concentrations results in cachexia: a wasting syndrome. Excessive amounts cause many clinical problems associated with autoimmune disorders.
* Cell apoptosis. This is programmed cell death that occurs when a cell is damaged beyond repair or infected with a virus. Apoptosis removes damaged cells preventing them from sapping further nutrients and stops the spread of viral infection. The products from the apoptosis of lymphoid organs accumulate and act as anti-inflammatory stimuli contributing to immune suppression or immune unresponsiveness as well as organ system dysfunction, increasing the risk of secondary opportunistic infections. (Necrosis which is unnatural cell death also occurs in sepsis leading to inflammation)
* Neutrophil hyperactivity. This is where there is an increased expression of surface antigens in the neutrophils (a type of white blood cell involved in immune response) causing them to bind tightly to the endothelial cells so they don't actually reach the site of bacterial infection to fight it.
* Poor glycaemic control. Critically ill patients exhibit insulin resistance and hyperglycaemia. The high blood sugar levels decrease the function of neutrophils including reduced bactericidal activity (killing bacteria).
* Lack of steroid hormones. In septicaemia bleeding into the adrenal gland may occur so cortisol (a steroid hormone) can no longer be secreted. Loss of cortisol results in low blood pressure that fails to respond to medication. This leads to Addison's disease, symptoms of which include: low blood pressure, sudden penetrating pain in the legs, lower back and abdomen, severe vomiting, diarrhoea, loss of consciousness, hypoglycaemia, confusion, lethargy, convulsions and fever.
Patients with septicaemia initially appear just generally unwell because the symptoms are not specific or characteristic. Therefore it is difficult to pick up and treat in the early stages so people develop more serious problems before the infection is properly diagnosed. The diagnosis is such a problem that at the moment septicaemia is a leading cause of death worldwide with an incidence of 3 in 1000 people (about 18million). In England and Wales there are roughly 31,000 cases of severe sepsis a year, with between 30-50% of cases leading to death.
Causes:
* Bacterial infection of wounds, burns, boils or abscesses
* Use of unsanitary equipment, such as instruments used in surgery or sharing needles or drug paraphernalia.
People are more susceptible to infection if they have a weakened immune system due to illnesses such as diabetes mellitus, or certain medications, older people and children are more at risk, as are intravenous drug users and ethanol abusers. These risks can be reduced by vaccinating children against the most common bacteria that causes septicaemia: meningococcus. Also you can reduce the risk of infection to wounds by keeping them clean and properly dresses.
When people contract this infection the immune system responds by releasing a high number cytokines which are hormones that fight infections. However, in this case the cytokines don't fight the infection but they damage organs and affect the blood circulation and can lead to sepsis. The immune response causes most of the symptoms and results in hemodynamic consequences (hemodynamic means the movement of blood and is the study of the forces that the heart develops to circulate blood) and organ damage. This is a medical emergency that requires treatment in an Intensive Care Unit with antibiotics and intravenous fluids. Artificial ventilation and dialysis may also be needed to support the lungs and kidneys. As well as this patients may require preventive care to protect them against deep vein thrombosis, (these are blood clots in deep veins, usually in the legs), stress ulcers and pressure ulcers which are discontinuations of the skin or open sores. Severe sepsis can lead to organ dysfunction, a low blood pressure, insufficient blood flow to one or more organs, septic shock and hyperfusion which is the significant loss of blood supply to tissues or organs. This response is called Systemic Inflammatory Response Syndrome (SIRS).
Information on Septicaemia PRESSURE SORES STAGES
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