Sepsis: what is it, the symptoms, the treatment
- What can contribute to the development of sepsis?
- Symptoms of sepsis
- Septicemia and septicemia
- Diagnosis of sepsis
- Features of treatment of sepsis
- Sepsis in newborns
Sepsis is a purulent-septic infectious disease that affects blood. Pathology is accompanied by the spread of infection throughout the body and very hard, creating a threat to the life of a sick person. Most often, the causative agents of sepsis are staphylococci, E. coli, streptococci, pneumococci. Sepsis often develops due to the unfavorable course of purulent inflammation of the soft tissues (abscess, peritonitis), against the background of a weakening of the defenses of the body.
What can contribute to the development of sepsis?
- Non-compliance with the rules of asepsis and antiseptics during the treatment of purulent wounds, with surgical interventions.
- Wrong selection of medicines, an error with the appointment of a dosage of antibacterial drugs.
- Immunological disorders.
- Progression of infectious agents resistant to antibiotics.
Symptoms of sepsis
The clinical picture for sepsis depends on the nature of the pathogen, which triggered the development of the disease. Often there is a combined form of pathology, which is based on the active multiplication of several pathogens.
The most dangerous is rightly considered staphylococcal sepsis, which is distinguished by its high antibiotic resistance. If the disease causes E. coli, then in the focus of inflammation formed pus. In this case, the area of the lesion has no clear forms.
Sepsis can have various manifestations. The course of the disease is often violent and rapid, so treatment must begin as early as possible, until irreversible consequences for the body. Recently, sepsis has been detected with erased symptoms or atypical forms of the infectious process.
The main signs of sepsis:
- high body temperature;
- An increase in leukocytes in the blood;
- Retardation of urine formation;
- Disruption of the circulatory system.
Septicemia and septicemia
Septicopaemia is a type of sepsis, in which the common symptoms of the disease are combined with the formation of characteristic purulent abscesses in various organs and tissues. Patients feel very poorly, body temperature is often increased to 39-40 ° C, consciousness is usually inhibited. The main pathogens for septicopyemia are staphylococcus and Pseudomonas aeruginosa. Septicopyemia develops less violently than septicemia. In patients with septicopyemia, purulent lesions of all vital organs (heart, liver, kidneys, brain) are detected.
With septicopyemia, cardiopulmonary insufficiency often develops rapidly. The defeat of the urinary system is accompanied by pain syndrome, oliguria. If there is purulent meningoencephalitis, patients notice the appearance of severe headaches, blurred consciousness, agitation, followed by a sharp depression and inhibition. Purulent foci are subject to urgent surgical removal with powerful antibiotic therapy.
For septicemia is characterized by a pronounced intoxication syndrome:
- Blurred consciousness;
- Pain in the muscles;
- bad feeling.
The infectious process proceeds swiftly. Septicemia develops mainly against the background of progression of streptococcal infection. Due to the development of hemorrhagic syndrome, a petechial rash occurs on the patient's skin, and hemorrhages also appear in the internal organs. Increases vascular permeability, there are internal swelling. The spleen is sharply enlarged, like the lymph nodes. Mucous and skin cyanotic (cyanotic).
Diagnosis of sepsis
The examination with sepsis is prescribed in accordance with the form of the disease and the localization of the septic focus. Can be conducted:
- Laboratory blood tests (neutrophilic leukocytosis with a shift of the leukocyte formula to the left, a decrease in hemoglobin), urine;
- Ultrasound of the kidneys, liver and other organs;
- X-ray diagnostics;
- CT scan;
- Bacterioscopy studies;
- Magnetic resonance imaging.
Features of treatment of sepsis
Sepsis is an emergency that requires emergency resuscitation. Treatment is reduced to fighting infectious agents and the progression of complications, which are often deadly to the patient. The appearance of symptoms of the development of renal failure requires hemofiltration, hemodialysis, urgent recovery of hemodynamic parameters.
If the patient has signs of heart failure, prescribe vasomotor drugs, as well as funds that stimulate the heart. Pulmonary insufficiency requires the use of an artificial lung ventilation device. Antibiotics are prescribed to patients with sepsis after receiving reliable results of a bacterioscopy study and determining the sensitivity of infectious agents.
Sepsis in newborns
Sepsis in the period of newborns is a very dangerous infectious disease, the pathogens of which can be various pathogenic and conditionally pathogenic microorganisms. In 50% of cases of infection, the cause lies in the progression of staphylococcal infection, the proliferation of hemolytic streptococcus. A little less often the disease occurs due to the active reproduction of Pseudomonas aeruginosa, Klebsiella, Escherichia coli. Sometimes the cause of development of sepsis in newborns is a mixed bacterial flora.
Entrance gate for infection:
- Umbilical wound;
- Damaged skin, mucous membranes;
- Genito-urinary organs;
- Gastrointestinal tract.
Sepsis of newborns often develops on the background of pyoderma, otitis, enteritis, intestinal infection, bronchitis, pneumonia, pharyngitis.
Who is at risk for sepsis among newborns? Predisposing factors and conditions:
- Hypoxia of the fetus;
- Birth trauma;
- Damage to the head and neck during labor;
- Prolonged artificial ventilation of the lungs;
- Probing the baby;
- Catheterization of veins;
- Immune disorders;
- HIV infection;
- Deep degree of prematurity;
- Heavy childbirth;
- Hereditary pathologies, accompanied by immunoreactivity;
- Conjunctivitis ;
- Complex operations conducted in the first weeks of a child's life.
Promote the development of sepsis in early childhood common pathology of pregnancy. Negative effects on the immunity of the fetus are venereal and genito-urinary infections, syphilis , HIV, chronic stomatitis, candidiasis, lack of nutrients in the future mother's diet, overfatigue of the woman, oxygen starvation of the fetus due to anemia and iron deficiency.
Symptoms of sepsis in newborns
In newborns, septicemia usually develops. The pathological process begins to progress against the backdrop of a long-pinched umbilical wound, abscesses on the body, pronounced stomatitis, conjunctivitis. Parents should alert the harbingers of the disease:
- Frequent regurgitation;
- Redness of the navel;
- Intertrigo, which are not amenable to treatment;
- Allocation of blood, pus, clear fluid from the umbilical wound;
- Passivity of the child;
- Insufficient weight gain;
- Anxiety of the newborn.
A characteristic sign of sepsis is an increase in body temperature. There may appear pustular rash all over the body. The skin acquires a characteristic earthy shade, the mucous membranes can turn yellow. With sepsis, there is an intoxication syndrome.
Affected by all the organs of the child, which leads to the progression of dangerous diseases and the development of the following violations:
- Tachycardia , bradycardia;
- Increase in the amount of urine;
- Hemorrhagic syndrome;
- Failures in the work of the adrenal glands, liver, kidneys;
- The appearance of chronic purulent foci in the bone tissue, brain, lungs, liver;
- Suppurative arthritis;
- Phlegmon in the digestive system.
With the development of the fulminant form of sepsis, there is a septic shock, which in most cases ends lethal. The disease leads to a sharp decrease in body temperature, accompanied by severe weakness, lethargy, increased bleeding, pulmonary edema, cardiovascular disorders, acute kidney failure.
Diagnosis and treatment of sepsis in children
The diagnosis of "sepsis of newborns" is determined by the clinical picture and the results of the examination. The main method of diagnosis is the delivery of blood for sterility. Also, a bacterioscopic examination of the umbilical wound is taken, a swab from the conjunctiva, the oropharynx is taken, the urine is examined for microflora, feces for the presence of a dysbacteriosis, and PCR analysis is performed. The task of specialists engaged in diagnosis, to differentiate sepsis from pneumonia, mediastenitis, enterocolitis, inflammation of the meninges, kandioza, enterovirus infection.
Treatment of sepsis in children is performed using resuscitation equipment and the most modern antibacterial drugs. Antibiotics are injected directly into the vein of the child - they act almost instantly and can effectively fight the infectious agent.
All purulent abscesses on the skin are opened, treating septic foci with anti-inflammatory, antimicrobial compounds, special enzymes that increase local immunity. To enhance the immune activity, hemosorption, plasmapheresis is carried out. Disintoxication measures can reduce the burden of kidney and liver, improve the child's condition and prognosis. It is recommended to feed the sick kid exclusively with breast milk, since it contains antibodies and helps to recover more quickly after the illness.