5 Surprising Facts About Sepsis — No, It’s Not Just an Infection

Most people probably know that getting sepsis is really bad, but far fewer understand what it is. A horrible infection? Blood poisoning?  

It’s true that sepsis is extremely dangerous. Every year in the U.S., 1.7 million people develop sepsis, and at least 350,000 adults die from it — in fact, it’s among the most common causes of death in hospitals. But the condition gets a lot more mysterious and complicated from there. Here are some surprising facts about sepsis.  

Sepsis itself isn’t an infection

One of the most common misconceptions about sepsis is that it’s an infection or “blood poisoning.” In fact, sepsis is your body reacting to an infection with a life-threatening dysregulated immune response that attacks your organs and tissues.  

Sepsis can happen in response to any kind of infection — bloodstream infections are one common cause, but sepsis can also be triggered by infections in your lungs, gastrointestinal tract, urinary tract, or even a cut or scrape on your skin. And it’s not only bacteria that can lead to sepsis — viral infections can also cause it, including COVID-19 or the flu, or even fungal infections, though that is rare. 

Sepsis can happen to anyone at any age, but babies and people over 65 with compromised immune systems are the most vulnerable. People who develop sepsis are also often struggling with another disease or health condition.  

“It’s this common final denominator of many diseases,” says David Carlbom, MD, a senior ICU physician at Harborview Medical Center and an expert in sepsis care. “You have a stroke that leaves you with impaired swallowing, and then you get pneumonia, and then that pneumonia becomes sepsis, and then you die of sepsis.” 

So while sepsis is responsible for 1 in 3 deaths in hospitals, it’s not always the reason the person was admitted. It also disproportionately affects people who have lower incomes and who live in places without access to good healthcare.  

You don’t always get a fever when you have sepsis

Sepsis is an especially hard condition to manage because 80% of sepsis cases start before the person gets to the hospital — and they might not realize they’re developing it. Unlike a stroke or cardiac arrest, the symptoms of sepsis can be subtle and vary widely. While some people get a fever, others get very cold and shiver. 

Symptoms can also include clammy skin, severe shortness of breath, rapid heart rate, slurred speech, disorientation and weakness. The Sepsis Alliance, an advocacy organization both Grainger and Carlbom work with, uses the acronym TIME:

• Temperature (higher or lower than normal)
• Infection (signs or symptoms of an infection)
• Mental decline (confused or sleepy)
• Extremely ill (severe pain, discomfort or shortness of breath)

Before Katy Grainger, a 59-year-old mother of two, went to the hospital with sepsis, she noticed an infected purple bump on her finger and didn’t feel well, but she didn’t have the symptoms she expected for sepsis.  

“I wasn’t checking my heart rate or breathing rate, the only thing I was checking is the one that we're all told, which is fever, but I never had a fever,” says Grainger.

The takeaway? Even if your temperature is normal, don’t hesitate to go to urgent care or the ER if you have an infection and you’re not feeling well.  

There is no test to diagnose sepsis  

Unfortunately, even if the person is in a hospital, it can still be hard for doctors to diagnose sepsis.  

“There is no blood test where you can be like, ‘Oh you have sepsis,’” says Carlbom. “It can start subtly.”  

Sepsis is unpredictable and researchers still don’t know why some infections trigger it and others don’t. And because the symptoms vary and are similar to those caused by other conditions, it requires doctors and nurses to pay extra attention and look at multiple tests to figure out what’s going on and diagnose it.  

Grainger recommends always having a friend or loved one with you in the hospital. They might notice changes in your symptoms and could ask about sepsis if they’re worried about it.  

“It’s always important to have someone there if possible, and have them grab a notebook and take good notes and pass information onto the next nurse or doctor who comes in,” she says.

After all, catching sepsis as early as possible is crucial in being able to stop it from becoming more severe. Every hour that treatment for sepsis is delayed, the likelihood of death goes up 8%.  

Sometimes the treatment for sepsis causes limb loss

When someone moves into septic shock, the most serious stage of sepsis, it’s not just about treating the infection.

“There’s also supporting the patient and keeping them alive long enough for antibiotics to work or even surgery to remove the source of infection,” says Carlbom.  

Because sepsis affects everyone differently, what works for one person might not work for another. One patient might have a heart that’s not pumping well, so too many fluids could be dangerous. Another might have a heart that’s working normally, but their blood vessels are too relaxed, so they need treatment to raise their blood pressure.  

Keeping the patient alive can involve extreme measures, like medications that cause the patient’s vessels to constrict, which stabilizes dangerously low blood pressure, but can also lead to limb loss. 

Sepsis patients often have PTSD and other long-term effects afterwards

Sepsis is a traumatic ordeal affecting nearly every organ and tissue in the body, so physical and psychological recovery can take a long time. About 50% of people who survive it often deal with long-term effects and complications, called post-sepsis syndrome. These can include memory problems, weakness, organ damage and cardiovascular issues.  

Grainger lost her fingertips and legs below the knee after she recovered from sepsis, and dealt with other issues, as well. Her lungs were weak and her vocal cords were damaged, making it hard to speak; and that’s not to mention the psychological recovery.

“When a person leaves the hospital after surviving sepsis, it’s not done, even if they’re not an amputee,” says Grainger. “It can be mental things like depression and anxiety, PTSD, memory issues, sleepiness and difficulty concentrating.”

There are things you can do to prevent sepsis

Because sepsis is triggered by an infection, the best way to prevent it is to take steps to avoid getting an infection in the first place. This means staying up to date on your vaccines, washing your hands well and taking care of wounds. 

And if you’re worried you might have sepsis, don’t put off talking to a doctor about it. Time is of the essence.