Recognizing the Signs: How Sepsis is Diagnosed

Let’s say you wake up feeling a bit off. Maybe you're feverish, sweaty and dizzy. You think it's just a bug, but as the day goes on, you gradually feel worse. Later, you go to the emergency room because you're struggling to breathe, your heart is racing and you're scared. Little do you know you might be battling something much more serious than the cold or flu – you might have sepsis.

Every year, around 1.7 million Americans get sepsis, which is the third leading cause of death in U.S. hospitals. Nearly 270,000 people die from sepsis each year.

What exactly is sepsis? Think of it like this: your body is a fortress, and it's always on guard, ready to defend against invaders like bacteria or viruses. Sometimes, those germs breach your body's defenses and enter your bloodstream, triggering an immune response. That response can spiral out of control, leading to sepsis – a condition where your body's defense mechanism becomes more harmful than the invader itself.

“Sepsis could start with something as simple as a tiny cut that doesn’t get cleansed properly,” explains Lisa Failace DNP, RN, CCRN-K. “It can start with anything, such as a mild ear infection, mild skin infection or even pneumonia. The difference is that at some point, the infection triggers the immune system to go into overdrive.”

During sepsis, the body's dysregulated immune response to an infection triggers widespread inflammation. This inflammation can lead to:

• Blood vessel dilation
• Increased blood vessel permeability
• Blood clot formation
• Impaired blood flow to vital organs

Without enough oxygen and nutrients, your organs start shutting down. That's why sepsis is such a serious (and dangerous) condition that requires a fast diagnosis and treatment.

The Urgency of a Sepsis Diagnosis

In an ideal scenario, you can identify and catch signs of an infection before it turns into sepsis. Your body often gives warning signs that something's not right. Keep an eye out for the earliest warning signs of an infection, such as:

• Cough
• Fever or chills
• Feeling achy all over
• Feeling more tired than usual
• Having trouble concentrating
• Sore throat

If your immune system goes into overdrive and sepsis sets in, you might experience more worrisome symptoms, such as:

• Confusion
• Feeling lightheaded or dizzy
• Very high body temperature or low body temperature
• Racing heart
• Shortness of breath or difficulty breathing

“Often we can diagnose a person with sepsis just by looking at them,” says emergency medicine physician William Fleischman, M.D. “When a patient comes to the emergency department with a fever and they look very ill, we can presumptively diagnose them within seconds and start treatment.”

And that’s important because sepsis is a medical emergency where every minute counts. Left untreated, it can wreak havoc on your body, leading to organ failure, septic shock and death within hours.

“Sepsis moves very quickly through the body for some people,” adds Dr. Fleischman. “The longer the wait to implement treatment, the sicker the patient may become.”

To make a formal diagnosis, health professionals first check vital signs like heart rate, blood pressure, and temperature. They then move fast to order diagnostic testing, including:

• Complete Blood Count (CBC): This test examines your white blood cell count and provides insights into your body's fight against infection.
• Blood Lactate Level: Elevated lactate levels in your blood may point to oxygen deprivation in tissues and organs, which is a hallmark of sepsis.
• Imaging Tests: X-rays or CT scans help identify the source of infection and guide treatment decisions.

Research shows that early treatment for sepsis reduces mortality and increases a person’s chance of recovery. Giving antibiotics early is critical. From there, doctors do their best to monitor for and treat any complications that could arise, such as:

• Blood clots
• Septic shock
• Tissue death (gangrene)
• Long-term weakness or cognitive issues

Protect Yourself From Sepsis

After doctors diagnose sepsis and begin treatment, recovery time can vary from person to person. Some people might start feeling better in a few days, while others might need weeks or even months to fully recover. It depends on how severe the sepsis was and if there were any complications.

It all goes back to diagnosis – the faster sepsis is caught, the earlier treatment can begin and the less damage it does to the body. The only way for that to happen is to pay attention to what your body is trying to tell you.

“Most people who have sepsis say they have an overwhelming feeling that they don’t feel well,” says Failace. “It goes beyond a regular cold and flu, and it doesn’t get better – it gets worse.”

If you’re a relatively healthy person and you only have a fever and body aches, checking in with your primary care provider or nearby urgent care is OK. But if you have a chronic condition or weakened immune system, you may need to seek care in the hospital for milder symptoms.

“If someone experiences a mental status change - they’re not acting appropriately, feels too weak to get out of bed, is not breathing normally, or can’t keep food or liquids down, it’s an emergency,” says Dr. Fleischman.

Next Steps & Resources

• Meet our sources: William Fleischman, M.D., Lisa Failace DNP, RN, CCRN-K
• Locate an emergency room or urgent care location near you.
• To make an appointment with a doctor near you, call 800-822-8905 or visit our website.