Cytokine Storm

Overview

A cytokine storm is a rare but serious immune reaction. Cytokines are chemical messengers that help the immune system fight infection. In a cytokine storm, these messengers flood the body and the immune response becomes too strong. This can harm the body's own organs and cause severe illness. It is not a disease by itself; it is a complication of another problem, such as a severe infection or some medical treatments.

Cytokine storm is rare. Most people with an infection do not develop it. It is a serious complication that doctors watch for in certain high-risk situations.

Anyone can develop a cytokine storm, but it is more likely in people who are very sick with certain infections, people receiving some immune treatments for cancer, and people with certain immune system conditions. It is not contagious.

Symptoms

Common symptoms

• High fever or chills
• Extreme tiredness or feeling very unwell
• Fast heartbeat
• Fast breathing or trouble breathing
• Dizziness or feeling faint
• Confusion or trouble thinking clearly
• Headache and muscle aches
• Nausea, vomiting, or diarrhea
• Rash or swelling

Symptoms in children

• Fever that may not come down
• Being very irritable or unusually sleepy
• Poor feeding or drinking
• Fast breathing
• Rash
• Tummy pain or vomiting
• Fewer wet nappies or signs of dehydration

Symptoms in older adults

• New confusion or forgetfulness
• Sudden weakness or falls
• Fast breathing
• Very low urine output
• Fever may be absent, so other signs matter more

Causes

Main causes

• Severe infections, including some viral and bacterial infections
• Sepsis, which is a body-wide reaction to an infection
• Some immune system conditions, including autoimmune and autoinflammatory conditions
• Some immune treatments for cancer
• Rare reactions to some medicines
• Major trauma, burns, or inflammation of the pancreas

Risk factors

• Being very unwell with a severe infection
• Having a weakened immune system
• Receiving certain immune treatments for cancer
• Having certain genetic immune system conditions
• Having a previous severe immune reaction, if your care team has told you this

When to see a doctor

See a doctor urgently if:

• You have a fever and are getting worse, not better
• You feel very dizzy, weak, or cannot keep fluids down
• You have fast breathing, a fast heartbeat, or a rash that is spreading
• You are caring for a child or older adult with these warning signs

Book a routine appointment if:

• You are recovering and have lingering tiredness or questions about follow-up
• You are about to start or have started a treatment that can affect the immune system
• You have had a severe immune reaction before and want to plan ahead

Diagnosis

There is no single test for cytokine storm. Doctors diagnose it by looking at the person's symptoms, doing a physical exam, and checking test results. They also look for the trigger, such as an infection, and check how well the organs are working.

Tests that may be done

• Blood tests to check blood cells, inflammation markers, liver, and kidney function
• Oxygen level checks and breathing tests
• Chest X-ray or other imaging scans
• Tests to look for infection, such as blood or urine tests
• Monitoring of blood pressure, heart rate, and urine output

What to expect at your appointment

If doctors suspect a cytokine storm, you will likely be assessed in hospital. You may need repeat blood tests and close monitoring. The care team will explain what they are checking and why.

Treatment

A cytokine storm is treated in hospital, often in an intensive care unit. The main goals are to support breathing and blood pressure, treat the trigger, and calm the overactive immune response. Treatment is chosen by a specialist care team based on the cause and how severe the illness is.

Self-care at home

• Do not try to treat this at home — seek urgent medical care if you have warning signs
• If you are recovering, follow your care team's advice and attend follow-up appointments
• Rest and drink fluids as advised during recovery
• Do not start new medicines for inflammation without asking your doctor or pharmacist

Medical treatments

Hospital care may include oxygen, fluids given into a vein, blood pressure support, close monitoring, and treatment of the infection or other trigger. Specialist medicines that calm the immune system may be used in some cases. The care team decides which treatments are right for each person.

When is surgery considered?

Surgery is not a treatment for cytokine storm itself. Surgery may be needed only for the condition that triggered it, such as an infection that needs drainage. The care team will explain if this applies.

Living with this condition

Recovery can take time. Some people feel very tired for weeks after a serious illness. Follow-up appointments help check how your organs are recovering and whether you need extra support.

Lifestyle tips

• Build rest into your day and return to activity slowly
• Keep vaccinations up to date as advised by your local health service
• Ask your doctor before starting strenuous exercise
• Tell your care team about any new symptoms or ongoing tiredness

Diet and exercise

Eat regular, balanced meals and drink enough fluids. Start gentle movement when your doctor says it is safe. Do not push through severe fatigue — rest is part of recovery.

Mental health and emotional wellbeing

A serious illness can cause fear, worry, or low mood. This is common and support is available. Talk to your care team if you feel overwhelmed. If you have thoughts of harming yourself, contact local crisis support or your local emergency number right away.

Prevention

You cannot fully prevent a cytokine storm, but you can lower your risk by preventing and treating infections early. If you receive treatments that affect the immune system, tell your care team about any new symptoms right away.

Vaccines

Stay up to date with vaccines recommended by your local health service. They help prevent some infections that can lead to severe illness.

Screening programmes

There is no routine screening test for cytokine storm. If you are having a treatment that can cause it, your care team will monitor you closely.

Complications

If left untreated

• Dangerously low blood pressure and shock
• Breathing failure
• Kidney injury
• Liver injury
• Blood clotting or bleeding problems
• Lasting organ damage
• Death in severe cases

Long-term outlook

With early recognition and hospital care, many people recover from a cytokine storm. Some people need a longer recovery and follow-up. Doctors are better at spotting and treating this serious reaction than in the past, and support is available.

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