Sepsis is a widespread infection in the blood. Septic shock is a serious condition that occurs when sepsis causes dangerously low blood pressure. When less blood flows to the organs, they can’t work properly. Low blood pressure and low blood flow to the organs can lead to organ failure. For this reason, septic shock can be a life-threatening condition.
Septic shock may also be called bacteremic shock or septicemic shock.
People with cancers of the blood, such as leukemia, are more likely to develop septic shock than those with solid tumours. It is usually caused by bacteria. Bacteria can get into the bloodstream through medical devices such as catheters and intravenous equipment. It can also get into the bloodstream during surgical or medical procedures.
Septic shock can also be caused by fungi or viruses.
A weakened immune system can lead to sepsis. Some cancers can weaken the immune system. It can also be weakened by chemotherapy and other drugs used in cancer treatment such as corticosteroids.
Some cancers or their treatments can lead to neutropenia, which is a low number of neutrophils. Neutrophils are a type of white blood cell that helps defend the body against bacteria and fungi. Chemotherapy or radiation therapy can cause neutropenia.
Symptoms of septic shock include:
- lowered alertness
- warm skin
- rapid heart rate
- rapid breathing
- low blood pressure
- skin rash
Other symptoms can develop as septic shock gets worse, including:
- below-normal temperature
- cool, pale and clammy arms or legs
- bruising or bleeding
- low or no urine output
Report symptoms to your doctor or healthcare team as soon as possible.
Your doctor will try to find the cause of the infection and how severe septic shock is. Septic shock is usually diagnosed by:
- physical exam
- complete blood count (CBC)
- blood cultures to identify the bacteria or organisms causing the infection
- blood gases to measure the level of oxygen in arterial blood
- blood chemistry tests
- urinalysis and urine culture (especially in people with urinary catheters)
- cultures of mouth sores, skin sores, stool or intravenous sites
- chest x-ray
- electrocardiogram (ECG)
- CT scan
Treating septic shock
Once the cause of septic shock is known, your healthcare team can treat it. People with septic shock are usually treated in an intensive care unit (ICU). The healthcare team will monitor you closely and check your blood pressure, heart rate and breathing often.
The following treatments are used for septic shock.
Increase blood pressure
You will be given fluids through a needle in a vein (intravenously) to raise your blood pressure. You may also be given medicines to raise your blood pressure.
If your blood pressure doesn’t increase with intravenous fluids and medicines, you may be given corticosteroids. These drugs act as an anti-inflammatory by reducing swelling and lowering the body’s immune response.
You may be given intravenous antibiotics to treat the infection that causes septic shock. The type of antibiotic used depends on the type of bacteria present. You may be given 2 or more antibiotics until the healthcare team finds out what caused the infection.
If the healthcare team thinks that the infection was caused by a catheter, they will remove it. You may also need to have surgery to drain an abscess or remove dead tissue that could have started the infection.
You may be given oxygen therapy if you have trouble breathing. If there are serious lung problems, you may be put on a ventilator.
If septic shock damages your kidneys, you may need dialysis. Dialysis removes wastes from the blood when the kidneys don’t work properly.