Understanding Sepsis - Frequently Asked Questions

Submitted by PatientsEngage on 28 August 2025
Stock pic of an image that says SEPSIS over a background of bacteria and text overlay on green strip - Understanding Sepsis

According to World Health Organisation, sepsis is one of the most frequent causes of death worldwide. From data published in 2020, there were 48.9 million cases and 11 million sepsis-related deaths worldwide, representing 20% of all global deaths. It is important that we understand what sepsis is, symptoms to watch out for and when to seek timely treatment.

Sepsis is a serious and potentially life-threatening condition that occurs when the body’s response to an infection spirals out of control, leading to widespread inflammation and organ dysfunction. Because it can progress rapidly, understanding sepsis is critical for early recognition and timely treatment. Yet, many people are unaware of what sepsis actually is, how it develops, and what symptoms to watch out for.

What is sepsis?

Sepsis is a life-threatening medical situation in which our body’s immune system goes into an overdrive and gives an extreme response to an infection while trying to fight it which further causes organ to dysfunction. This is one such reaction of our defence mechanism where it causes harm to its own tissues and organs, and it can lead to shock, failure of multiple organs and even death sometimes if not addressed in time.

What causes sepsis?

Any infection can lead to sepsis. The most common ones are pneumonia, urinary tract infections (UTIs), skin infections, or abdominal infections (peritonitis, appendicitis, gall bladder inflammation/infection) and infections of the brain. Bacteria are usually the culprits, but viruses, parasites and fungi can also trigger it.

How common is sepsis?

Sepsis is one of the most frequent causes of death worldwide. Sepsis is a substantial public health issue in India. Data from a 2025 Indiaspend report states that one in two Intensive Care Unit (ICU) patients had sepsis, and among them 27.6% died. A 2017 study estimated 11.3 million sepsis cases in India with subsequent 2.9 million deaths. A 2024 study published in a journal of the National Institutes of Health (NIH) states that sepsis patients had a mortality rate of 36.3% and a 50.8% mortality rate for septic shock.

Who is at a higher risk of sepsis?

Sepsis can affect people of any age, but some age groups and people ate at a higher risk like:

  • Infants (babies <1 year), younger babies (neonates) or premature babies
  • Older adults >=65 years
  • People who are hospitalized
  • People who have some chronic medical issues like Diabetes, chronic kidney disease, cirrhosis etc.
  • People who have a urinary catheter or long-term IV line for some medical issues
  • Post operative patients
  • Post major trauma
  • People with weak immunity, like those who may have HIV or cancer. Also, people who take medications that lower immunity (immunosuppressants for cancer, autoimmune diseases etc.)

What are the stages of sepsis?

Clinically, there are three stages of sepsis:

  • Sepsis: As discussed earlier it is an extreme dysfunctional immune response to a viral, bacterial, or fungal infection, which causes rapid breathing and heart rate and a fever.
  • Severe sepsis: It is a progression from sepsis where organ damage begins due to low blood pressure and or inflammation.
  • Septic shock: Septic shock is the most severe stage of sepsis. It is characterized by extremely low blood pressure that does not respond to the usual IV fluid treatment. Due to the extremely low Blood pressure, the blood from cannot carry sufficient oxygen to vital organs which leads to multi-organ failure (including the lungs, kidneys, and liver) and may be life threatening.

What are the early warning signs and symptoms?

Common signs and symptoms include:

  • Fever or low temperature and shivering
  • Confusion
  • Difficulty in breathing/ Fast or shallow breathing
  • Cold, clammy, and sweaty skin
  • High heart rate, weak pulse, or low blood pressure
  • Low urine output
  • Severe body pain

Symptoms in children include:

  • Fast breathing
  • Convulsions
  • Pale skin
  • Lethargy/listlessness
  • Excessive drowsiness
  • Skin feels cold to the touch

Sepsis may progress to septic shock. Septic shock is a severe drop in blood pressure. Progression to septic shock raises the risk of death. Symptoms of septic shock include:

  • Not being able to stand up/Obtundation
  • Extreme drowsiness
  • Person appearing extremely confused

How is sepsis diagnosed?

There are no strict criteria to diagnose sepsis. The doctor usually starts treatment based on the signs and symptoms like shallow breathing, weak pulse, and low blood pressure and or fever.

Tests usually involve blood tests like Complete blood count, blood culture, kidney and liver function test, lactate etc.) and urine test.

Scans like Ultrasound, CT and MRI may also be done.

The Sequential Organ Failure Assessment (SOFA) score is used to assess organ dysfunction, which is a key feature of sepsis. For patients with a suspected infection who are in the ICU, the SOFA score is a better predictor of in-patient mortality than the SIRS criteria and qSOFA score.

For patients with a suspected infection who are not in the intensive care unit (ICU), the quick-SOFA (qSOFA) score is a better predictor of inpatient mortality than the SOFA score. Patients with ≥ 2 of the following criteria meet criteria and should have further clinical investigation:

  • Temperature > 38° C (100.4° F) or < 36° C (96.8° F)
  • Heart rate > 90 beats per minute
  • Respiratory rate > 20 breaths per minute or partial pressure of arterial carbon dioxide (PaCO2) < 32 mm Hg
  • White blood cell (WBC) count > 12,000/mcL (12 × 109/L), < 4,000/mcL (4 × 109/L), or > 10% immature (band) forms

Patients with ≥ 2 of the following qSOFA criteria should have further clinical and laboratory investigation:

  • Respiratory rate ≥ 22 breaths per minute
  • Altered mentation
  • Systolic blood pressure ≤ 100 mm Hg

tool that is also used by doctors to help identify patients at risk of sepsis and poor prognosis. It uses three criteria: respiratory rate, altered mental status (Glasgow Coma Scale), and systolic blood pressure.

How is sepsis treated?

Treatment for sepsis is most effective when started early. Usually, the doctor would like to increase the blood pressure to save the blood flow to vital organs. The treatment may include:

  • The doctor may give some Antibiotics if there is a bacterial infection.
  • IV (intravenous) fluids: are usually given to maintain the blood flow to your organs and prevent your blood pressure from dropping too low.
  • Medications to increase blood pressure (Vasopressor medications) will usually be given.
  • Supportive measures: In case of an organ failure, the treatment for support of that organ begins such as dialysis for kidney failure or mechanical ventilation for respiratory failure.
  • Sometimes surgery is also needed to remove any damaged tissue.

What is the outcome/prognosis of Sepsis?

The outcome of septic shock can depend on a variety of factors, which include:

  • Age- older adults and neonates and infants are more susceptible
  • Person’s overall health status
  • Whether a person has other chronic diseases which makes the outcome poorer
  • If person requires ventilatory support, it may affect the prognosis
  • People with poor kidney function may have a poorer outcome
  • The type of pathogen/organism that causes the infection
  • The number of organs affected by septic shock
  • Patient’s sensitivity to antibiotics

The prognosis of sepsis depends on the above and the promptness of diagnosis and treatment. Most patients with mild sepsis recover completely with rapid medical attention. Severe sepsis and septic shock are associated with higher chances of fatality, around 30-40% of people with septic shock may die even with treatment. Another grave cause of concern is the long-term survival. More than 50% of sepsis survivors may die within five years, mostly due to complications or underlying health issues. The longer lasting effects like organ damage or post-sepsis syndrome, may also affect the quality of life of sepsis survivors.

Can you prevent sepsis?

Not all cases of sepsis can be prevented, but you may lower the risk by:

  • Staying up to date with vaccines (like flu vaccine annually and pneumococcal vaccine for pneumonia)
  • Maintaining good hygiene and handwashing
  • Treating any infections early and timely
  • Ensuring proper infection control measures in hospitals

What is the recovery like after sepsis?

After sepsis, the actual complete recovery may take weeks or months. Some people experience post-sepsis syndrome, which comprises of symptoms like tiredness, memory or cognitive issues, muscle or joint pain and weakness. Rehabilitation, good nutrition, counselling and regular follow-up medical care can augment your recovery.

Many people survivors of sepsis or septic shock may appear to be fine, but they may have still have some issues like depression or anxiety. In some cases, they may be diagnosed with post-traumatic stress disorder (PTSD). PTSD may occur as a part of the post-sepsis syndrome (PSS) and is not uncommon for people who were treated in an ICU, more so, if they needed to be on a ventilator. Post-sepsis syndrome is still not well known in the medical community.

One of the many unknown facts about sepsis is that it’s not known why some survivors recover completely and others don't. It is immensely helpful to find a doctor who specializes in pain management (such as at a pain management clinic) and or seeing a therapist/ counsellor to learn coping techniques for the pain, fatigue, and cognitive issues.

What are the red flags to watch out for and when you should seek immediate medical attention?

If anyone who has an infection develops sudden fever, confusion, shortness of breath, rapid heartbeat, or extremely low blood pressure, they should see a doctor immediately. Acting fast and timely intervention makes all the difference and changes the outcome.

Can you have sepsis again (is there a chance of recurrence)?

More than 40% of previous sepsis survivors and approximately one-third of all sepsis survivors do get hospitalized again within three months of their first diagnosis of sepsis. It is commonly due to a repetition of the episode of sepsis or a new infection.

How to prevent recurrence?

To help prevent recurrence of sepsis, it is essential to treat any new infections immediately and follow medical advice given by your doctor. Any associated or coexisting medical conditions should be well managed. Adult vaccinations should be up to date, any wounds should be properly managed, good hygiene should be maintained, and timely medical intervention and antibiotic use when advised for infections are imperative preventive measures.

Reference

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13/Sep/2025
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