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Septic shock
Septic shock is a serious condition that occurs when an overwhelming infection leads
to life-threatening low blood pressure.
Septic shock occurs most often in the very old and the very young. It also occurs in
people who have other illnesses.
Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also
cause the condition. Toxins released by the bacteria or fungi may cause tissue
damage, and may lead to low blood pressure and poor organ function. Some
researchers think that blood clots in small arteries cause the lack of blood flow and
poor organ function.
The body also produces a strong inflammatory response to the toxins. This
inflammation may contribute to organ damage.
Risk factors for septic shock include:

Diseases of the genitourinary system, biliary system, or intestinal system
Diseases that weaken the immune system such as AIDS
Indwelling catheters (those that remain in place for extended periods, especially
intravenous lines and urinary catheters and plastic and metal stents used for
Long-term use of antibiotics
Recent infection
Recent surgery or medical procedure
Recent use of steroid medications

Septic shock can affect any part of the body, including the heart, brain, kidneys, liver,
and intestines. Symptoms may include:

Cool, pale extremities

High or very low temperature, chills
Low blood pressure, especially when standing
Low or absent urine output

Rapid heart rate
Restlessness, agitation, lethargy, or confusion
Shortness of breath
Skin rash or discoloration

Exams and Tests

Blood tests may be done to check for infection, low blood oxygen level, disturbances
in the body's acid-base balance, or poor organ function or organ failure.
A chest x-ray may show pneumonia or fluid in the lungs (pulmonary edema).
A urine sample may show infection.
Additional studies, such as blood cultures, may not become positive for several days
after the blood has been taken, or for several days after the shock has developed.

Septic shock is a medical emergency. Patients are usually admitted to the intensive
care unit of the hospital.
Treatment may include:
Breathing machine (mechanical ventilation)
Drugs to treat low blood pressure, infection, or blood clotting
Fluids given directly into a vein (intravenously)
There are new drugs that act against the extreme inflammatory response seen in septic
shock. These may help limit organ damage.
Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -may be required. This can only be done with special equipment and intensive care

Outlook (Prognosis)
Septic shock has a high death rate. The death rate depends on the patient's age and
overall health, the cause of the infection, how many organs have failed, and how
quickly and aggressively medical therapy is started.

Possible Complications

Respiratory failure, cardiac failure, or any other organ failure can occur. Gangrene
may occur, possibly leading to amputation.

When to Contact a Medical Professional

Go directly to an emergency department if you develop symptoms of septic shock.

Prompt treatment of bacterial infections is helpful. However, many cases of septic
shock cannot be prevented.

Alternative Names
Bacteremic shock; Endotoxic shock; Septicemic shock; Warm shock

Vincent J, Septic Shock. In: Fink MP, Abraham E, Vincent J, Kochanek PM, eds.
Textbook of Critical Care. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap
Jones AE, Kline JA. Shock. In: Marx, JA, ed. Rosen's Emergency Medicine:
Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap
Munford RS. Severe sepsis and septic shock. In: Fauci AS, Harrison TR, eds.
Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill;
2008:chap 265.