Sepsis, also known colloquially as blood poisoning, is one of the most common causes of death worldwide, but the disease is hardly known. The annual World Sepsis Day on September 13 aims to remedy the situation with campaigns and education. Peter Lemberger, chief physician for anesthesia and intensive care at the Ebersberg district clinic, talks about the dangerous disease in an interview.
SZ: Mr. Lemberger, what exactly is sepsis anyway?
Peter Lemberger: We speak of sepsis when germs such as bacteria, viruses, fungi or a mixture of these have entered the bloodstream. The cause is always an infection. The body defends itself against the invaders in the blood and so severe symptoms of the disease usually occur, such as high fever, muscle pain, rapid breathing and shortness of breath. Some people are also confused or have trouble speaking. As the disease progresses, cardiovascular collapse, kidney, liver, or multiple organ failure can occur, and finally, sepsis can lead to death. Another risk of the disease: the germs can also settle in other places in the body, for example on the heart valves, which leads to endocarditis, i.e. inflammation of the heart valves, or on the spine with the result that one or more vertebral bodies become damaged ignite.
Can something like this happen with every infection?
Theoretically yes. Common causes are pneumonia, urinary tract infections, abdominal infections, wound infections and meningitis. But viral diseases such as flu and Covid-19 can also lead to sepsis. People with a weakened immune system, i.e. the elderly and infants, as well as people with chronic, organic diseases, for example diabetics and people who have to take cortisone regularly, for example due to an autoimmune disease, are at high risk. In everyday life, however, sepsis occurs rather rarely. Sometimes germs get into the bloodstream during an operation, for example when an abscess or inflamed tonsils are removed. In older people, intestinal or pneumonia can be the cause. At Klinik Ebersberg we have about two patients a week, mostly older, who need intensive care treatment because of sepsis.
Some symptoms also show up in other illnesses, such as the flu or a stroke. How can sepsis be clearly identified?
On the one hand, those affected are doing very badly, they quickly feel increasingly ill and will see a doctor, who should refer them to a clinic immediately. If a patient is suspected of having sepsis, a blood culture is created in our laboratory and microbiologically examined to identify the germs and to find out what type it is. We get the result after about two to three days.
What does treatment look like then?
The first priority is to find the cause and treat it as well as side effects such as cardiovascular problems. If it is obvious that the cause is a bacterial infection, the patient is given a broad-spectrum antibiotic immediately and pending laboratory results. As soon as it is clear which bacteria are involved, it is replaced by another antibiotic that acts specifically against these germs. If it turns out to be a fungus, the patient is given antifungal medication. If viruses are in the blood, caused by pneumonia or Covid-19, for example, we can only treat the symptoms, for example ventilate the patient, and thus bridge the time until the body has healed itself. There are no specific drugs against viruses.
About a quarter of people with sepsis die. What are the reasons for that?
Either the disease has already caused irreversible damage to organs and organ failure occurs, or the bacteria responsible for the sepsis are resistant to antibiotics and the cause cannot be remedied, or patients are already so weakened by serious underlying diseases that they need another , cannot survive a serious illness such as sepsis.
What advice do you have for people at increased risk of sepsis?
Have infections treated by your family doctor as quickly as possible, strengthen your immune system and see a doctor immediately if you experience the symptoms mentioned.