DEAR DOCTOR K:
My father had routine surgery. Soon after, he developed something called sepsis that almost killed him. He’s OK now, but I’d like to understand what happened to him.
He and you are lucky. Not everyone makes it. Sepsis is a condition in which the immune system goes awry. Think of the immune system as our personal army, with an arsenal of weapons. It is meant to protect us from foreign invaders (like germs). Unfortunately, in attacking foreign germs, it sometimes can go overboard — and its weapons can injure us.
The condition that often triggers sepsis is a bacterial infection. Other causes can lead to sepsis, including autoimmune diseases, surgery and severe burns. In all of these cases, the immune system is being called to help us heal from some injury. However, when the immune response is both too vigorous and too prolonged, healthy tissues can be damaged.
Sepsis is treated with antibiotics; the idea is to kill the bacteria that have triggered the attack by the immune system. Drugs that increase blood pressure may also be given since sepsis often results in low blood pressure. A person may also need supplemental oxygen and intravenous fluids, depending on his or her symptoms.
Sepsis is fairly common. There are between 1 million and 2 million cases every year in the United States. A decade ago, I was one of those cases. I had many of the main features of sepsis. Fairly suddenly, I felt completely exhausted and had a very high fever. I developed a rapid heart rate, rapid breathing, low blood pressure, pale and mottled skin, very high numbers of white blood cells, very high blood markers of inflammation, and somewhat low levels of oxygen in the blood.
I don’t think I had an alteration in my mental state, as some people with sepsis do. Then again, a person with an altered mental state isn’t the best judge of whether he has an altered mental state.
I was pretty sick for a few days, but I recovered fully. I was lucky. If sepsis is not promptly recognized and treated, it can cause the lungs, kidneys, liver, heart and brain to fail.
Certain people appear to be at increased risk for sepsis. They include people over age 65, people with diabetes, people with cancer, and people who are taking drugs that suppress the immune system.
Two common bacterial infections that can cause sepsis, particularly in older people, are pneumonia and urinary tract infection. I urge my older patients to call me promptly if they develop an unusual cough or breathlessness (possible symptoms of pneumonia), or painful and frequent urination (possible symptoms of urinary infection).
It was a weird experience to be a doctor, to have a sudden medical emergency, and to know exactly what was happening. Fortunately, I was at the hospital when I got sick and got prompt treatment. I’ll never know for sure, but I think it saved my life.