Sepsis is a life-threatening medical emergency that can develop when the body's response to an infection causes damage to its own tissues and organs. It can progress quickly and may lead to organ failure or death if treatment is delayed.
Although sepsis can affect anyone, certain people have a higher risk, including older adults, infants, people with weakened immune systems, and those living with chronic medical conditions.
Recognising the early warning signs and seeking immediate medical attention can make a significant difference. In this guide, we explain what sepsis is, its early symptoms, who may be at risk, and why prompt treatment matters.
What Is Sepsis?
Sepsis is the body's extreme and harmful response to an infection. Normally, the immune system fights infections caused by bacteria, viruses, fungi, or other microorganisms.
However, sometimes the body's response becomes uncontrolled. Instead of protecting the body, it triggers widespread inflammation and can interfere with normal blood flow and organ function.
Sepsis can affect several organs, including:
The lungs
The kidneys
The heart
The brain
The liver
Without timely treatment, sepsis can progress to septic shock, a severe condition involving dangerously low blood pressure and serious problems with organ function.
Important: Sepsis is a medical emergency. If you suspect sepsis, seek emergency medical care immediately. Do not wait for all the symptoms to appear.
10 Early Warning Signs of Sepsis
Sepsis symptoms can vary depending on the infection, the person's age, and their overall health. Some symptoms may appear similar to those of other illnesses, making early recognition particularly important.
Here are 10 warning signs to know.
1. Fever or Unusually Low Body Temperature
A high temperature is a common sign of infection and may occur in someone developing sepsis.
However, some people with sepsis develop an unusually low body temperature instead of a fever. This can be particularly concerning in older adults and people with weakened immune systems.
2. Rapid Heartbeat
A faster-than-normal heartbeat may occur as the body responds to infection and tries to maintain blood circulation.
If a rapid heartbeat occurs alongside confusion, breathing difficulties, fever, or severe illness, it requires urgent medical assessment.
3. Rapid or Difficult Breathing
Breathing faster than usual can be an early warning sign of sepsis.
Some people may experience shortness of breath, chest discomfort, or difficulty getting enough air.
Severe breathing difficulties require immediate emergency assistance.
4. Confusion or Disorientation
Sepsis can affect the brain and cause changes in mental function.
Possible symptoms include:
New confusion
Difficulty concentrating
Unusual behaviour
Disorientation
Difficulty staying awake
Sudden confusion, particularly in an older adult with a possible infection, should never be ignored.
5. Extreme Pain or Discomfort
Some people with sepsis experience severe pain or discomfort that seems much worse than expected.
The pain may occur in different parts of the body depending on the underlying infection.
Severe or unexplained pain accompanied by signs of infection needs urgent medical attention.
6. Clammy or Sweaty Skin
Skin may become unusually cold, damp, or sweaty when circulation is affected.
Some people may also appear pale or feel unusually cold.
These symptoms can occur in serious infections and should be assessed alongside other warning signs.
7. Reduced Urination
A noticeable decrease in urine output can indicate that the kidneys are not receiving enough blood flow or are becoming affected by severe illness.
Warning signs may include:
Passing much less urine than usual
Going for unusually long periods without urinating
Very dark urine alongside other symptoms of serious illness
Reduced urination in someone with a suspected infection needs urgent medical assessment.
8. Severe Weakness or Extreme Fatigue
Sepsis can cause profound weakness and exhaustion.
A person may struggle to perform normal daily activities, feel unusually weak, or become too unwell to get out of bed.
Extreme weakness accompanied by other signs of infection should be taken seriously.
9. Skin Discolouration or Mottled Skin
In some cases, sepsis can affect blood circulation and cause changes in skin appearance.
The skin may look unusually pale, bluish, grey, or mottled.
These changes can be more difficult to recognise on darker skin tones. Check areas such as the palms, soles, lips, and inside the eyelids as well.
10. Feeling Extremely Unwell
A person developing sepsis may describe feeling seriously ill or feeling that something is very wrong.
This may occur with a combination of symptoms such as fever, chills, weakness, rapid breathing, confusion, or severe discomfort.
Trusting these warning signs and seeking prompt medical care is important, especially when an infection is getting worse rather than improving.
Can Sepsis Develop Without a Fever?
Yes. Sepsis does not always cause a fever.
Some people may have a normal temperature or an unusually low temperature. Older adults, newborns, and people with weakened immune systems may not develop the typical fever response.
Therefore, the absence of fever does not rule out sepsis.
Other warning signs, such as confusion, rapid breathing, extreme weakness, reduced urination, and unusual skin changes, are also important.
If someone appears seriously unwell or has signs of sepsis, seek emergency medical care even if their temperature is normal.
When Should You Seek Emergency Medical Help?
Sepsis can worsen rapidly. Seek emergency medical care immediately if you or someone else has a suspected infection accompanied by warning signs such as:
New confusion or difficulty waking up
Severe breathing difficulties or very rapid breathing
Pale, blue, grey, or mottled skin
Extreme pain or a feeling of being seriously unwell
Very little or no urine
Signs of rapidly worsening illness
Do not wait for symptoms to become severe or for a complete set of warning signs to appear.
In the United States, call 911 for a medical emergency. In the United Kingdom, call 999 for an emergency. Follow the emergency service's instructions.
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What Causes Sepsis?
Sepsis usually develops when an infection triggers an abnormal and overwhelming response from the immune system. Although bacterial infections are a common cause, viral and fungal infections can also lead to sepsis.
An infection does not always lead to sepsis. However, certain infections can become serious, particularly when they are not recognised or treated promptly.
The most common sources of infections that may lead to sepsis include:
1. Lung Infections
Pneumonia is one of the common infections associated with sepsis.
When harmful microorganisms infect the lungs, they can cause inflammation, fluid accumulation, fever, coughing, and breathing difficulties. In some cases, the infection can trigger sepsis and affect other organs.
2. Urinary Tract Infections
Urinary tract infections (UTIs) can sometimes spread to the kidneys and cause a more serious infection.
Kidney infections, particularly in older adults and people with certain medical conditions, can sometimes lead to sepsis.
Possible symptoms include painful urination, frequent urination, fever, back or side pain, and chills.
3. Abdominal Infections
Infections inside the abdomen can also lead to sepsis.
Examples include:
Appendicitis
Infection of the gallbladder
Peritonitis
Abdominal abscesses
Severe infections involving the intestines
These conditions may require urgent treatment, including antibiotics or surgery, depending on the cause.
4. Skin and Soft Tissue Infections
Skin infections can sometimes spread into deeper tissues or the bloodstream.
Examples include cellulitis, infected wounds, abscesses, and serious infections following injuries or surgical procedures.
Increasing redness, swelling, warmth, pain, pus, or rapidly spreading skin changes should be medically assessed.
5. Bloodstream Infections
Microorganisms can enter the bloodstream from an infection elsewhere in the body or through certain medical procedures and devices.
A bloodstream infection may cause a serious immune response and can be associated with sepsis.
However, sepsis can also occur without a confirmed infection in the bloodstream.
Who Is at Higher Risk of Sepsis?
Anyone can develop sepsis, but some people have a higher risk of developing a severe infection or experiencing complications.
Important risk groups include:
1. Older Adults
People aged 65 and above have a higher risk of sepsis.
Age-related changes in the immune system and the presence of other medical conditions can increase vulnerability to serious infections.
2. Infants and Young Children
Newborns and young children, particularly babies younger than one year, may be more vulnerable to serious infections.
Symptoms in infants can be difficult to recognise and may include poor feeding, unusual sleepiness, breathing difficulties, or changes in body temperature.
3. People with Weakened Immune Systems
People with weakened immune systems may have difficulty fighting infections.
This group can include individuals receiving chemotherapy, people taking certain immune-suppressing medicines, organ transplant recipients, and those living with certain immune disorders.
4. People with Chronic Medical Conditions
Certain long-term health conditions can increase the risk of developing severe infections.
Examples include:
Diabetes
Chronic kidney disease
Chronic lung disease
Cancer
Certain cardiovascular conditions
Managing existing medical conditions and seeking early treatment for infections are important steps in reducing complications.
5. Hospitalised Patients
People receiving treatment in hospitals, particularly those in intensive care units, may have an increased risk of infections.
Certain medical procedures and devices, such as urinary catheters, breathing tubes, and intravenous lines, can provide opportunities for microorganisms to enter the body.
6. People Who Have Recently Had Surgery
Surgical wounds can sometimes become infected.
Infections may develop at the surgical site or elsewhere in the body during recovery. Early recognition of wound infections and appropriate medical follow-up are important.
7. People with Recent Severe Infections
A person who has recently experienced pneumonia, a kidney infection, or another serious infection may be at risk of further complications.
Symptoms that worsen or return after initial improvement should be assessed promptly.
What Are the Stages of Sepsis?
Sepsis is commonly described in terms of its severity and the effects it has on the body's organs.
Older medical terminology used three stages: sepsis, severe sepsis, and septic shock. However, modern clinical definitions no longer use severe sepsis as a separate diagnostic category.
Today, healthcare professionals assess sepsis based on infection-related organ dysfunction and the presence of septic shock.
1. Sepsis
Sepsis occurs when the body's abnormal response to an infection causes life-threatening organ dysfunction.
Possible signs include:
Changes in mental status
Rapid breathing
Reduced urine output
Low blood pressure
Changes in blood circulation
Abnormal blood test results
Sepsis requires urgent medical assessment and treatment.
2. Sepsis with Organ Dysfunction
Sepsis can affect one or more vital organs, including the kidneys, lungs, heart, liver, and brain.
Examples of organ dysfunction include:
Acute kidney injury
Difficulty breathing due to lung dysfunction
Reduced blood circulation
Confusion or reduced alertness
Abnormal liver function
The severity depends on which organs are affected and how well they respond to treatment.
3. Septic Shock
Septic shock is a particularly dangerous form of sepsis.
It involves serious circulatory and cellular abnormalities. Blood pressure may remain dangerously low despite adequate fluid replacement, and medicines called vasopressors may be needed to maintain blood pressure.
Septic shock can cause severe damage to multiple organs and requires intensive medical treatment.
Important: These descriptions are not a step-by-step progression that every patient experiences. Sepsis can become severe quickly, and treatment should never be delayed while waiting for a particular stage.
What Complications Can Sepsis Cause?
Sepsis can affect multiple organs and may cause serious short-term and long-term complications.
Some people recover fully, while others experience lasting health problems.
1. Kidney Damage
Sepsis can reduce blood flow to the kidneys and cause acute kidney injury.
Severe cases may require temporary dialysis or other supportive treatment.
2. Lung Damage
Sepsis can cause serious lung inflammation and breathing difficulties.
Some patients develop acute respiratory distress syndrome (ARDS), a condition that makes it difficult for the lungs to provide enough oxygen.
3. Heart Problems
Sepsis can affect the heart's ability to pump blood effectively.
This may contribute to poor circulation and reduced oxygen delivery to vital organs.
4. Brain and Nervous System Problems
Some people experience confusion, memory difficulties, problems concentrating, or other changes in mental function during and after sepsis.
These symptoms may improve over time, although some people experience longer-lasting effects.
5. Blood Clotting Problems
Sepsis can interfere with the body's normal blood-clotting system.
In severe cases, it may cause disseminated intravascular coagulation (DIC), a serious condition involving abnormal clot formation and bleeding.
6. Multiple Organ Dysfunction
Severe sepsis can cause several organs to stop functioning properly.
This condition is known as multiple organ dysfunction syndrome (MODS) and may be life-threatening.
7. Long-Term Recovery Problems
Some survivors experience ongoing physical, emotional, or cognitive difficulties after hospital discharge.
Possible problems include:
Persistent fatigue
Muscle weakness
Sleep disturbances
Anxiety or depression
Memory and concentration difficulties
Reduced physical stamina
Recovery varies from person to person and may require rehabilitation and continued medical support.
Can Sepsis Be Prevented?
Not every case of sepsis can be prevented, but reducing the risk of infections and treating them early can help.
Practical prevention measures include:
Keep vaccinations up to date according to medical advice.
Wash hands regularly with soap and water.
Clean and cover wounds properly.
Seek medical advice for infections that worsen or do not improve.
Follow medical instructions when taking prescribed antibiotics.
Keep diabetes and other chronic conditions well managed.
Follow proper infection-control guidance during hospital care.
Attend recommended follow-up appointments after surgery or serious infections.
People at higher risk should seek medical advice early when they develop symptoms of an infection.
Remember that antibiotics should only be used when prescribed by a qualified healthcare professional. They do not treat viral infections and should never be taken without appropriate medical guidance.
How Is Sepsis Diagnosed?
Diagnosing sepsis can be challenging because its symptoms may resemble those of other medical conditions. There is no single test that can confirm or rule out sepsis on its own.
Healthcare professionals assess a person's symptoms, medical history, physical examination findings, and test results to identify possible infection-related organ dysfunction.
Common diagnostic tests include:
1. Blood Tests
Blood tests help healthcare professionals assess how the body is responding to infection and whether organs are affected.
They may include:
Complete blood count (CBC) to assess white blood cells and other blood components.
Blood chemistry tests to evaluate kidney and liver function.
Blood glucose measurements.
Blood tests to assess blood clotting.
Lactate measurement to help assess problems with tissue oxygen delivery and circulation.
A high or low white blood cell count may occur in sepsis, but it does not confirm the condition by itself.
2. Blood Cultures
Blood cultures are used to identify bacteria or fungi in the bloodstream.
They can help doctors determine which microorganism is causing an infection and select appropriate antimicrobial treatment.
Whenever possible, blood cultures are collected before antibiotics are administered. However, collecting samples must not delay urgent treatment.
A negative blood culture does not rule out sepsis.
3. Urine Tests
Urine samples may be examined to identify urinary tract or kidney infections.
A urine culture can help identify the microorganism responsible for the infection and guide treatment.
4. Imaging Tests
Imaging tests may be used to locate the source of infection or identify complications.
Depending on the suspected infection, doctors may recommend:
Chest X-ray
Ultrasound
CT scan
Other appropriate imaging investigations
For example, a chest X-ray may help identify pneumonia, while an abdominal scan may help detect an internal infection or abscess.
5. Organ Function Assessment
Doctors also monitor how well important organs are working.
They may assess:
Blood pressure
Heart rate
Breathing rate
Oxygen levels
Urine output
Kidney and liver function
Mental alertness
These assessments help determine the severity of illness and guide treatment decisions.
How Is Sepsis Treated?
Sepsis requires immediate medical treatment, usually in a hospital. Treatment aims to control the underlying infection, support affected organs, and prevent further complications.
The treatment plan depends on the source of infection, the severity of the illness, the patient's age, and their overall health.
1. Antibiotics
Antibiotics are commonly used when bacterial sepsis is suspected.
Doctors generally start appropriate broad-spectrum antibiotics as quickly as possible, ideally within one hour when sepsis or septic shock is recognised as an emergency.
Treatment may later be adjusted based on culture results and the suspected source of infection.
Antibiotics do not treat viral or fungal infections. Other appropriate medicines may be required depending on the microorganism involved.
2. Intravenous Fluids
Sepsis can affect circulation and reduce blood flow to vital organs.
Intravenous (IV) fluids may be given to improve circulation and support blood pressure.
The amount and type of fluid depend on the patient's condition. Doctors monitor the response carefully, particularly in people with heart or kidney problems.
3. Vasopressor Medicines
If blood pressure remains dangerously low despite appropriate fluid treatment, doctors may use medicines called vasopressors.
These medicines help narrow blood vessels and raise blood pressure to maintain blood flow to vital organs.
Norepinephrine is commonly used as the first-choice vasopressor in septic shock.
4. Oxygen Therapy and Breathing Support
Some people with sepsis develop breathing difficulties or low oxygen levels.
Treatment may include:
Supplemental oxygen
High-flow nasal oxygen
Non-invasive breathing support
Mechanical ventilation through a breathing tube in severe cases
The choice depends on the person's breathing and oxygen requirements.
5. Treatment of the Infection Source
Controlling the source of infection is an important part of sepsis treatment.
Depending on the cause, doctors may need to:
Drain an infected abscess.
Remove infected or damaged tissue.
Treat an infected wound.
Remove or replace an infected medical device.
Perform surgery to control an internal infection.
Antibiotics alone may not be sufficient when an infection requires a procedure or surgery to control its source.
6. Kidney Support
Severe sepsis can affect kidney function.
Some patients develop acute kidney injury and may need dialysis if the kidneys cannot adequately remove waste products and excess fluid.
Dialysis may be temporary or, in some cases, needed for longer periods depending on kidney recovery.
7. Intensive Care Unit (ICU) Treatment
People with severe sepsis or septic shock may require treatment in an intensive care unit.
ICU care provides continuous monitoring and advanced support for vital organs.
Treatment may involve:
Continuous blood pressure monitoring
Advanced respiratory support
Vasopressor medicines
Kidney support
Careful fluid management
Close monitoring of organ function
The goal is to stabilise the patient and prevent further organ damage.
How Long Does Sepsis Treatment Take?
The length of treatment varies considerably.
Some people improve within a few days, while others need several weeks of hospital treatment, especially if they develop septic shock or organ damage.
The duration depends on:
The type and source of infection
How quickly treatment begins
Whether the infection is controlled
The number of organs affected
The person's age and general health
The presence of other medical conditions
There is no fixed recovery timeline for everyone with sepsis.
Can You Recover Fully from Sepsis?
Yes. Many people recover from sepsis, particularly when the infection is recognised and treated promptly.
However, recovery depends on the severity of the illness and whether complications develop.
Some people return to their usual health, while others need additional support after leaving the hospital.
Recovery may involve:
Follow-up medical appointments
Physical rehabilitation
Gradual return to normal activities
Nutritional support when needed
Mental health support
Monitoring of kidney, lung, or other organ function
People who experience ongoing symptoms should discuss them with their healthcare team.
What Is the Survival Rate of Sepsis?
Sepsis is a serious condition, but survival is possible with timely and appropriate medical care.
The outcome depends on several factors, including the severity of infection, the organs affected, the presence of septic shock, age, and other medical conditions.
Septic shock carries a particularly high risk of death compared with less severe forms of sepsis.
There is no single survival percentage that applies to every patient. Statistics from hospitals and research studies may differ because they involve different patient populations and illness severities.
Early recognition, prompt treatment, and appropriate organ support can improve the chances of survival.
What Is Post-Sepsis Syndrome?
Some people experience lasting physical, emotional, and cognitive problems after recovering from sepsis. This is sometimes called post-sepsis syndrome.
Possible symptoms include:
Persistent tiredness
Muscle weakness
Difficulty sleeping
Memory problems
Difficulty concentrating
Anxiety or depression
Reduced ability to perform everyday activities
These symptoms may continue for weeks or months, and some people experience longer-lasting difficulties.
Anyone experiencing ongoing problems after sepsis should speak with a healthcare professional. Rehabilitation and supportive care may help improve recovery.
Frequently Asked Questions About Sepsis
1. What is the first warning sign of sepsis?
There is no single first warning sign. Sepsis may begin with symptoms such as fever or unusually low temperature, rapid breathing, a fast heartbeat, severe discomfort, or new confusion.
2. Can sepsis develop suddenly?
Yes. Sepsis can develop and worsen rapidly. Someone with an infection may become seriously unwell over a short period, which is why emergency medical assessment is important when warning signs appear.
3. Is sepsis contagious?
Sepsis itself is not contagious. However, the infection that causes it may sometimes spread from person to person, depending on the microorganism involved.
4. Can a urinary tract infection cause sepsis?
Yes. A urinary tract infection can sometimes spread to the kidneys and lead to a more serious infection that triggers sepsis.
5. Can pneumonia lead to sepsis?
Yes. Pneumonia is a recognised source of infection that can lead to sepsis, particularly in older adults and people with weakened immune systems or chronic medical conditions.
6. Can sepsis occur without a fever?
Yes. Some people with sepsis have a normal temperature or an unusually low temperature. The absence of fever does not rule out sepsis.
7. Is sepsis curable?
Many people recover from sepsis with prompt and appropriate treatment. However, severe cases can cause organ damage and may be life-threatening.
8. How quickly should sepsis be treated?
Sepsis is a medical emergency and requires immediate assessment. When sepsis or septic shock is recognised as an emergency, appropriate treatment, including antibiotics for suspected bacterial infection, should begin without unnecessary delay.
9. Can diabetes increase the risk of sepsis?
People with diabetes may have an increased risk of developing serious infections and sepsis. Keeping blood glucose levels under appropriate control and seeking early medical attention for infections are important.
10. Can sepsis return after recovery?
A person can develop sepsis again if they experience another serious infection. Previous sepsis does not provide complete protection against future episodes. People with a history of sepsis should seek medical advice promptly if they develop signs of infection.
Conclusion
Sepsis is a life-threatening medical emergency that can develop when the body's response to an infection causes damage to its own tissues and organs. It can affect people of all ages, although older adults, infants, and individuals with certain chronic medical conditions may face a higher risk.
Recognising warning signs such as confusion, rapid breathing, extreme discomfort, reduced urination, and unusual skin changes can help people seek medical attention sooner.
Sepsis requires urgent hospital treatment, which may include antibiotics, intravenous fluids, medicines to support blood pressure, and intensive care when necessary.
Although recovery is possible, some people experience lasting health problems after sepsis. Understanding the warning signs, preventing infections where possible, and seeking immediate medical care when someone becomes seriously unwell are essential steps in protecting health.
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Medical Disclaimer
This article is intended for general educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.
Sepsis is a medical emergency. If you suspect sepsis, seek emergency medical care immediately. Do not delay treatment or rely on online information to diagnose or manage the condition.
Always consult a qualified healthcare professional regarding symptoms, medical conditions, and treatment decisions.
References
Centers for Disease Control and Prevention (CDC) – About Sepsis
https://www.cdc.gov/sepsis/about/index.htmlNational Institute of General Medical Sciences (NIGMS) – Sepsis
https://www.nigms.nih.gov/education/fact-sheets/Pages/sepsis.aspxNational Health Service (NHS) – Sepsis
https://www.nhs.uk/conditions/sepsis/Society of Critical Care Medicine (SCCM) – Surviving Sepsis Campaign
https://www.sccm.org/SurvivingSepsisCampaign/HomeWorld Health Organization (WHO) – Sepsis
https://www.who.int/news-room/fact-sheets/detail/sepsisSinger M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.
https://doi.org/10.1001/jama.2016.0287
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