Columnists Health Health Matters

HEALTH MATTERS: Sepsis is difficult to predict, diagnose and treat

On the morning that actress Liana Mendoza was scheduled to be on a movie set, she was in the emergency room fighting for her life.

“The morning before my call time to be on set, I had a fever of 101.8 and thought it was the flu, but on the second day my fever shot up to 102.9 and my body ached,” Mendoza said. “I realized something might be terribly wrong.”

Medical professionals recommend that if a high fever lasts more than 24 hours, seek medical care immediately.

Mendoza’s decision to go to the emergency room instead of reporting to work saved her life. The diagnosis: Sepsis.

Sepsis is difficult to predict, diagnose and treat. It happens quickly and initially can be confused with other conditions.

The Centers for Disease Control and Prevention defines sepsis as a complication caused by the body’s overwhelming and often life-threatening response to a minor or major infection limited to an area of the body (tooth abscess, flu, urinary tract infections, gastroenteritis, etc.) or can be widespread through the bloodstream.

When it comes to sepsis, time matters. It is a medical emergency.

If treatment is delayed, in a matter of hours it can cause tissue damage, organ failure and death.

Anyone who develops an infection is at risk; however, sepsis typically affects the very young or the very old. People with chronic illnesses, such as diabetes, AIDS, cancer and kidney or liver disease are also at increased risk, as are those who have experienced a severe burn or physical trauma from wounds or injuries caused by incidents such as a result of a car crash or a bullet wound.

Other risk factors include a weakened immune system from treatments such as chemotherapy for cancer, or the use of steroids for inflammatory conditions; certain addictive habits, such as alcohol or drugs; receiving certain treatments or examinations; if your spleen is surgically removed (the spleen helps fight certain infections); or from other genetic factors.

Sepsis symptoms

Four types of infections most often associated with sepsis include infections of the lungs, urinary tract, skin and gut. Common bacteria that can cause sepsis are Staphylococcus aureus, Escherichia coli (E. coli), and some types of streptococcus.

In Mendoza’s case, she unknowingly was suffering from a urinary tract infection, which can affect any part of your urinary system — kidneys, ureters, bladder and urethra. Symptoms include pain with urination, frequent urination and feeling the need to urinate despite having an empty bladder.

About 150 million people are affected by urinary tract infections annually. However, women are at greater risk of developing them than men.

“I had a bladder infection but didn’t know because I had no other symptoms,” Mendoza said. “It didn’t hurt when I urinated but apparently the sepsis started from a simple bladder infection.”

She does recall being extremely lethargic and dizzy.

Sepsis is an under-recognized public health crisis and not widely discussed even when it strikes more than 1 million people every year.  It’s been estimated that between 28 and 50 percent of those people die — far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined.

Sepsis - what happens

“Despite advances in treatment, septic shock still has a mortality rate of approximately 40 percent,” said Andrew Rhodes, co-chair of the executive committee of the Surviving Sepsis Campaign. “Even for those who survive a sepsis event, it causes considerable long-term health issues. Getting the right management early in the disease process is vital to improving the chances of a good outcome.”

The symptoms can be described by using the first letter of sepsis:

Severe shortness of breath; sleepy, confused.

Extremely cold hands or feet; pain or general discomfort.

Palpitations or racing heart; pale or discolored skin.

Slurred speech.

I‘ve never felt so bad or I feel I might die.

Shivering uncontrollably, fever or very cold.

“The big bottom line remains on early recognition of infection and organ dysfunction,” said Dr. Laura E. Evans, co-chair of the executive committee of the Surviving Sepsis Campaign. “We continue to make a strong recommendation that hospitals and health care systems implement programs that help identify at-risk patients early. There’s implicit recognition that just being a good clinician is probably not enough; you need a system in place to help recognize patients early.”

For hospital personnel, sepsis can be decreased by strictly following hand washing and hygiene protocols.

Mendoza says she learned a lot about sepsis while she was administered treatment that included over five IV antibiotics.

“I work in the entertainment industry and was concerned about getting my cast mates or the production crew sick,” she said. “I found out that sepsis may be contagious, depending on where the infection started and the organism causing the sepsis (for example, if the infection started in the lung or with certain forms of brain infections).”

Mendoza’s origin of the infection was her bladder and; therefore, poses no risk to anyone but herself.

The treatment of severe sepsis and septic shock may include antibiotics to treat the infection; surgery to control the source of the infection; fluids through the intravenous; drugs to raise the blood pressure or improve the function of the heart; organ support, such as artificial ventilation for the lungs and kidney support.

Despite early detection, antibiotic therapy and the best possible care, some patients may not respond to treatment, but rather develop further organ failure and die. The majority of patients who survive and appear to be healthy may develop an array of long-term cognitive and functional impairments.

With determination and following doctor’s orders, Liana Mendoza kicked sepsis out of her system. The face of the Latin Business Association and now a self-described face of sepsis, Mendoza is on a mission to educate people and give them inspiration and hope if it happens to them. (Courtesy Photo)
With determination and following doctor’s orders, Liana Mendoza kicked sepsis out of her system. The face of the Latin Business Association and now a self-described face of sepsis, Mendoza is on a mission to educate people and give them inspiration and hope if it happens to them. (Courtesy Photo)

“Thankfully, I responded well to all the treatments, but my doctor advised me to drink more water to flush out bacteria and avoid soft drinks and caffeine,” said Mendoza, who does not drink alcohol and is otherwise very health conscious and works out daily. “Often times we get busy, but ignoring the fact that we need a minimum of eight glasses a day is not an excuse for me any longer.”

Mendoza is a survivor of an unpredictable and potentially deadly infection.  To that end, she believes she is obligated to be a face of sepsis and continue the conversation to educate everyone about a silent infection that can lead to death.

Centers for Disease Control and Prevention – www.cdc.gov/sepsis

Journal of American Medical Association – www.Jamasepsis.com

Mayo Clinic – www.mayoclinic.org

MarieLemelle2016

Marie Y. Lemelle, MBA, a public relations consultant, is the owner of Platinum Star PR and can be reached on Twitter @PlatinumStar or Instagram @PlatinumStarPR. Send “Health Matters” related questions to healthmatters@wavepublication.com and look for her column in The Wave.