Alternate Names: Bacteremic shock; Endotoxic shock; Warm shock

Causes and Risks:

Septic shock occurs more often in the very old and the very young, and in people with other underlying illnesses. Many bacterial organisms can cause septic shock. Toxins released by bacteria can cause tissue damage and interfere with normal blood circulation.

The risk factors include underlying illnesses such as diabetes; hematologic cancers; and diseases of the genitourinary system, liver or biliary system, and intestinal system. Other risk factors are recent infection, prolonged antibiotic therapy, and a recent surgical or medical procedure. The incidence is approximately 3 out of 1,000,000 people annually.

See also:

• meningococcemia
• Waterhouse-Friderichsen syndrome
• DIC (disseminated intravascular coagulation)

Prevention:

Prompt treatment of infections caused by bacteria is helpful. However, many cases cannot be prevented.

Symptoms:

• low blood pressure, systolic usually less than 90
• drop in blood pressure when sitting or standing
• rapid heart rate (tachycardia)
• cool, pale extremities
• elevated temperature
• restlessness, agitation, or confusion
• low urine output
• chills

Additional symptoms that may be associated with this disease:

• swelling, overall
• joint pain

Signs and Tests:

• blood gases may reveal low oxygen concentration and acidosis
• blood cultures to detect infection
• cardiac monitoring is consistent with high output

Treatment:

Septic shock is a medical emergency; patients are admitted to intensive care.

The objective of treatment is to:

• provide oxygen and treat respiratory distress if present
• elevate the legs to maximize blood flow to the brain
• administer intravenous fluids to restore blood volume and vasoactive drugs to treat low blood pressure
• treat underlying infections with antibiotics

Hemodynamic monitoring to evaluate the pressures in the heart and lungs in treatment of shock requires specialized equipment and intensive care nursing.

Prognosis:

Septic shock has a high death rate, exceeding 50%, depending on the type of organism involved.

Complications:

Respiratory or cardiac failure can occur.

Go to the emergency room if symptoms of septic shock are present. You may need to call an ambulance if you have no means of transportation or if you feel like you are unable to drive.