The Health | MARCH, 2019
18
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Sepsis development.
Please, don’t
chop off my leg!
Sepsis – the Silent killer
I
t is such a tragedy when our loved ones are
advised to amputate their infected leg. Alas, why
do the amputation needed in the first place?
Well, the infected limb will cause sepsis if it is
not amputated, and sepsis can lead to death.
Statistically, someone on earth dies of sepsis
every 4 seconds! Sepsis actually causes more deaths
than heart attacks, cancer and accident does. In
Malaysia, one out of three hospitalizations is caused
by sepsis. And one out of those three hospitalized
patient dies of sepsis. Sepsis is the silent killer and is
a real emergency!
What is sepsis?
By Dr Tan Toh Leong
The word is a derivation of the Greek word “SIPSI”,
which means ‘make rotten’. Sepsis is a blood infection
caused by bacteria, virus, fungus or even parasite. It is
a condition when our body’s response to an infection
goes wrong and starts to injure its own tissue and
organs.
When our body catches a cold or has an infected
wound, if not treated early and appropriately, it can
result in sepsis. Sepsis is the final common pathway to
death in the majority of infectious diseases worldwide.
Most infections can cause sepsis, including lung infec-
tion, flu, dengue, urine infection, skin infection, Ebola
infection and abscess.
80 percent of infections leading to sepsis are
contracted outside the hospital. Anyone irrespective
of age can get it. However, there are special high-risk
groups that can contract sepsis easier than others.
Some are more prone than others
80 percent of
infections leading
to sepsis are
contracted outside
the hospital. Anyone
irrespective of age
can get it. However,
there are special
high-risk groups
that can contract
sepsis easier than
others.”
These high-risk groups are the elderly over the age
of 60, very young children, individuals with chronic
illness of the lungs, kidney, liver and heart, those with
diabetes, AIDS, cancer and ones without spleens.
Those with prolonged stress, poor/lack of sleep,
rushing for the deadlines, lack of exercise and poor
eating habits, can easily contract sepsis too. Prolonged
stress causes chronic inflammation and later, poor
immunity, thereby causing one’s body to be more
susceptible to infection.
Interestingly, studies have found that sepsis pres-
ents differently according to gender and race. Men
have better immunity compare to women. However,
once men are infected, they are presented with sepsis
earlier than women due to their body’s overt inflam-
mation/immunity responses.
Coloured races have better immunity and stronger
inflammation responses which prevent them from
falling sick. However, once they have an infection, it
will progress quickly into sepsis as compared to Cau-
casians and fair-skinned Asians. The chances of organ
failure and death are higher among them compared to
Caucasian and Asian races. Vice versa, Asians are more
prone to infection but progresses to sepsis much later
as compared with other races.
How to know if we have sepsis?
How can sepsis be detected? It is simple. Recognizing
the following six symptoms may give one a clue that
someone you love might have an infection which has
progressed onto sepsis. The symptoms include;
• Slurred speech/confusion
• Extreme shivering or muscle pain
• Passing no urine all day
• Severe breathlessness
• ‘Feeling like one is going to die’
• Skin mottled or discoloured
When we detect someone suspected to have
sepsis, we need to get them to hospital immediately.
Community clinics will not able to handle sepsis
because the patient needs to be hospitalized and
given intravenous antibiotic for a long period of time.
During hospitalization, the doctors will identify the
source of infection and eradicate it via antibiotic and,
sometimes surgical removal of the dead tissue from
the infected site may be required to be done.
Septic shock
Sepsis may progress to septic shock. In septic shock,
the patients’ blood pressure gets low and one may fall
critically ill. These patients need ICU admission for
intravenous drug to support their blood pressure in
order to buy time for the antibiotic to work.
The effect
Sepsis affects 25 to 30 million people a year, of which
one third had died. Many survivors face long term
consequences, such as loss of limb, poor memory,
poor concentration and post-traumatic stress dis-
order. How do we prevent sepsis? It can simply be
prevented by vaccination, clean hygiene, easy access
to healthcare facility, clean water, a healthy lifestyle
and last but not least awareness of it causes.
Death by sepsis is easily preventable. By increasing
sepsis awareness amongst us, we can prevent sepsis
consequences which could be fatal. If one gets an
infection, which might progress into sepsis, it must be
recognised quickly, the patient should be hospitalized
and rapidly treated with antibiotics.
Early treatment of infection and early recognition
of sepsis saves lives. Share the knowledge of these six
symptoms of sepsis with your loved ones. Join the
World Sepsis Day (September 13 annually) to create
sepsis awareness and spread the methods to prevent
it. We can make a difference to ourselves, our loved
ones, and to our friends. Please share this out - it could
save someone’s life! — The Health
Dr Tan Toh Leong is a Senior Lecturer, Consultant Emer-
gency Physician, and Student Affair Coordinator (Alumni)
at Hospital Canselor Tuanku Muhriz UKM.