Signs of Sepsis: Be on Guard

As an emergency medicine physician I see many patients presenting with fever, cough and varying degrees of feeling tired and wiped out. The great majority of these patients are not very ill and can be discharged home simply with something for their fever such as acetaminophen (Tylenol) or ibuprofen (Motrin/Advil). But hiding amongst the weeds is a serious killer named sepsis, which early in its presentation can appear like a run of the mill mild case of the flu.

Sepsis is an overwhelming infection that can affect multiple parts of the body and in its most severe form can result in multiple organ failure and death. Sepsis is often caused by the body’s response to a bacterial infection, but can also be from a viral, parasitic or fungal infection as well. In essence your body is trying to fight the infection by going into overdrive. This reaction from your body initiates inflammation, blood clotting, and multiple organ dysfunction. Shockingly common medical conditions can lead to sepsis such as pneumonia, urinary tract infections, ear infections or surgery.


The Annals of Emergency Medicine rank sepsis as a killer. More people suffer from severe sepsis than congestive heart failure, breast cancer, colon cancer and AIDS combined. This medical condition kills more Americans than heart attacks.


Healthcare providers diagnose sepsis using a two-step process. First they identify or suspect the patient has an infection. This is performed by doing a history and physical and can be confirmed through simple tests such as a urine test or chest x-ray. Second they identify two Systemic Inflammatory Response Syndrome Criteria or SIRS. The SIRS criteria for adults is listed below:

Temperature greater than 38 C (100.4 F) or lower than 36 C (96 F)

Pulse greater than 90 beats per minute

Respiratory rate greater than 20 breaths per minute

White blood cell count less than 4,000 or greater than 12,000 or greater than 10% bands


Once sepsis is identified more extensive treatment is needed and further studies are performed to identify which organ systems are involved such as the lungs, heart, kidneys, or brain. Identifying sepsis early is crucial since many studies have shown that early aggressive treatment such as intravenous fluids and broad-spectrum antibiotics can decrease the risk of death by one half. Anytime you have flu like symptoms or an infection be on guard for sepsis.