What Happens When Someone Goes Into Septic Shock?
Key takeaways:
Septic shock occurs when the body is overwhelmed by a serious infection. When this happens, someone’s blood pressure drops dangerously low and their organs start to fail.
Septic shock is a life-threatening medical emergency that requires care in the intensive care unit (ICU). People with this condition need powerful antibiotics and medications to raise their blood pressure.
Septic shock has a high mortality rate. But early diagnosis and treatment raises the chances of survival.
Septic shock is an advanced stage of infection and sepsis. When someone gets an infection, their immune system — the body’s army — rallies the troops to fight it off. But just like in war, the troops themselves can cause damage during the fight. Sepsis occurs when someone’s immune response to an infection starts to take a negative toll on the body.
If sepsis is left untreated — or when someone’s body is not responding to treatment — septic shock can develop. When someone is in septic shock, they have a very low blood pressure (hypotension). This affects blood flow to vital organs. Septic shock is life-threatening because it can quickly progress to widespread organ failure.
How does septic shock differ from sepsis?
Sepsis is a spectrum. It can be divided into three stages:
Sepsis = infection + sepsis symptoms
Severe sepsis = infection + sepsis symptoms + organ damage
Septic shock = infection + sepsis symptoms + organ damage + low blood pressure
Septic shock is the most life-threatening stage of sepsis. The risk of sepsis progressing to septic shock goes up by 4% to 9% with every hour that treatment is delayed.
What are the causes of septic shock?
Just like sepsis, septic shock is caused by the immune system’s response to a severe or worsening infection. Bacterial infections are the most common cause of sepsis. But viruses can cause sepsis, too.
Some of the more common causes of sepsis include:
Genital infections, like pelvic inflammatory disease, toxic shock syndrome, or prostatitis
Bloodstream infections
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What are the symptoms of septic shock?
The symptoms of septic shock can come from the infection itself, the developing organ failure, or even low blood pressure. They are similar to sepsis symptoms, but are often more severe and pronounced. Common symptoms include:
Fever and chills
Fast heart rate
Rapid breathing
Confusion or dizziness
Lethargy or drowsiness
Bluish discoloration of the fingers or lips (cyanosis)
If someone also has organ failure, their symptoms depend on which organ is shutting down:
Kidney failure: When the kidneys fail, they can’t make urine. Toxins and fluids can then build up in the body. This causes swelling and fluid buildup throughout the body. It can also lead to shortness of breath and confusion.
Lung failure: When the lungs fail, they become stiff and wet. This causes rapid or labored breathing.
Heart failure: When the heart fails, it can’t pump blood properly. This can lead to a buildup of fluid in the legs (causing swollen legs) and lungs (causing shortness of breath).
Sepsis symptoms in children are similar to those in adults. Symptoms in kids may also include:
Poor feeding
Limpness or poor muscle tone
Fast and shallow breathing
Cold, clammy, or mottled skin
Poor urine output (no wet diapers)
How is septic shock diagnosed?
To diagnose septic shock, providers take into account:
Vital signs
Physical exam
Diagnostic tests
Abnormal vital signs are the first clue that a person has sepsis. Someone who has septic shock often has:
Fever
Rapid breathing
Fast heart rate
Low blood pressure
But vital signs are not the whole story. Providers also look for signs of septic shock when they perform a physical exam. They look for both signs of infection, as well as signs of organ failure described above. For example, cold or blue fingers and toes may suggest a lack of blood flow to the arms and legs. Or, confusion or loss of consciousness can mean a lack of blood flow to the brain.
The next step is to run tests to confirm the diagnosis. These usually include:
Blood, urine, and sputum (stuff coughed up from the lungs) tests
Imaging tests, like chest X-rays or CT scans
Treatments for septic shock
Studies show that rapid initiation of treatment for sepsis saves lives.
There are three overall goals of treatment:
Treat the underlying infection. This requires strong antibiotics given through an intravenous (IV) catheter.
Raise blood pressure. Providers use IV fluids and special medicines called vasopressors to raise the blood pressure. This helps improve blood flow and prevent further organ damage.
Support breathing. Most people with septic shock have trouble breathing. There are many ways and devices that providers use to make sure the body is getting enough oxygen. This often requires intubation and a mechanical ventilator (life support machine).
What happens if you leave septic shock untreated?
Septic shock is life-threatening. With treatment, about 35% of people still die from septic shock. So without treatment, it causes death. But the faster treatment is started, the better the chances of survival.
How long does it take to recover from septic shock?
Recovery from septic shock looks different for every person. It depends on the type of infection that caused septic shock, the severity of organ damage, and the person’s other medical conditions. Some infections are easier to treat than others. Younger people with little to no health problems are more likely to recover quicker than older people with many health problems.
After recovery, there can be longer-term consequences of septic shock:
Some people might need physical therapy or occupational therapy to regain strength.
Others might develop post-sepsis syndrome, which affects up to 50% of sepsis survivors. Post-sepsis syndrome can cause a wide range of symptoms, like fatigue, sleeping problems, and shortness of breath.
Psychological symptoms due to the trauma of being sick and hospitalized — like flashbacks, memory loss, and depression — can also occur. But, with time and help, recovery is possible.
The bottom line
Sepsis and septic shock are life-threatening medical emergencies. Septic shock is a more advanced stage of sepsis that is defined by extremely low blood pressure. While the mortality rate is high, survival is possible with early treatment. If you are concerned that you or someone you care about has an infection that is not getting any better, get medical help. This way you can prevent more advanced stages of infection before they develop.
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References
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Centers for Disease Control and Prevention. (2020). Pneumonia.
Centers for Disease Control and Prevention. (2021). What is sepsis?
Johns Hopkins Medicine. (n.d.). Prostatitis.
Johns Hopkins Medicine. (n.d.). Vital signs (body temperature, pulse rate, respiration rate, blood pressure).
Laura, E., et al. (2021). Surviving sepsis campaign: International guidelines for the management of sepsis and septic shock 2021. Critical Care Medicine.
National Heart, Lung, and Blood Institute. (2022). What is respiratory failure?
National Kidney Foundation. (n.d.). Dialysis.
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Rivers, E., et al. (2001). Early goal-directed therapy in the treatment of severe sepsis and septic shock. New England Journal of Medicine.
Sepsis Alliance. (2021). Post-sepsis syndrome.
Singer, M., et al. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). Journal of the American Medical Association.
