Sepsis

Overview

Sepsis is a life-threatening condition that happens when the body's response to an infection goes into overdrive. Normally, your immune system (the body's defence against illness) sends signals to fight off infection. In sepsis, those signals become extreme and start to damage the body's own tissues and organs. Think of it like a fire alarm that, instead of just alerting you, sets the whole building on fire. Sepsis is sometimes called 'blood poisoning', though it is not really poisoning — it is the body's own reaction that causes harm. It can develop quickly and become very serious in a short time, which is why recognising it early is so important.

Sepsis is more common than many people realise. Globally, it affects tens of millions of people every year. In the UK alone, the NHS estimates around 245,000 people develop sepsis each year. It is not a rare event — it can affect anyone, at any time, following any infection.

Sepsis can affect people of all ages, from newborn babies to older adults. However, some groups are more vulnerable, including very young children (especially babies under one year), adults over 75, people with long-term health conditions such as diabetes or kidney disease, people with weakened immune systems (the body's defence system), pregnant women and those who have recently given birth, and people who have recently had surgery or a serious injury. That said, even previously healthy people can develop sepsis — no one is completely immune.

Symptoms

Common symptoms

• A high temperature (fever) above 38°C (100.4°F) — or sometimes a very low temperature below 36°C (96.8°F)
• Feeling extremely unwell — often described as the worst you have ever felt
• Chills and shivering, even when you feel very warm
• A fast heart rate (your heart beating much quicker than normal)
• Breathing faster than usual
• Confusion, disorientation, or unusual changes in behaviour or mental state
• Feeling dizzy or faint
• Clammy, pale, or mottled (blotchy) skin
• Nausea (feeling sick) or vomiting
• Severe muscle pain or weakness
• Not passing urine (wee) as much as usual, or not at all

Symptoms in children

• Breathing very fast — faster than you would normally expect
• A fit or convulsion (uncontrolled shaking of the body)
• Skin that looks mottled (blotchy), bluish, or very pale
• A rash that does not fade when you press a glass against it
• Feeling extremely sleepy and being very difficult to wake up
• Feeling abnormally cold to touch
• Refusing to eat or drink and being unusually quiet or not responding normally
• In babies: a bulging fontanelle (the soft spot on a baby's head)

Symptoms in older adults

• Sudden confusion or feeling 'muddled' — sometimes the only obvious sign in older people
• Slurred speech or difficulty finding words
• Extreme weakness or falls
• Feeling very cold or shivering without an obvious reason
• Skin colour changes — looking very pale, yellowish, or mottled
• Not drinking fluids or passing urine as usual
• Worsening of an existing health condition without a clear reason

Causes

Main causes

• Bacterial infections — the most common cause; bacteria can enter from almost anywhere in the body
• Pneumonia (lung infection) — one of the most frequent starting points for sepsis
• Urinary tract infections (UTIs) — infections of the bladder or kidneys that spread to the blood
• Abdominal infections — such as appendicitis or a perforated (ruptured) bowel
• Skin infections — including infected wounds, burns, or cellulitis (a deep skin infection)
• Meningitis — infection of the membranes surrounding the brain and spinal cord
• Viral infections — including influenza (flu) and, importantly, COVID-19
• Fungal infections — less common but can cause sepsis, especially in people with weakened immune systems
• Infections related to medical devices — such as catheters (tubes used to drain urine) or intravenous (IV) drip lines

Risk factors

• Age — being very young (under 1 year) or older (over 75) increases risk
• A weakened immune system — from conditions such as HIV, cancer, or treatments like chemotherapy
• Diabetes (a condition affecting blood sugar control)
• Chronic (long-term) kidney, liver, or lung disease
• Recent surgery, invasive medical procedures, or serious injury
• Pregnancy or having recently given birth
• Use of medical devices that enter the body, such as urinary catheters or IV drip lines
• Living in care homes or hospitals, where infections can spread more easily
• Alcohol dependence or heavy alcohol use, which can weaken the immune system
• Malnutrition (not getting enough nutrients from food)
• Genetic factors — some people may be more likely to develop severe sepsis due to their genes

When to see a doctor

See a doctor urgently if:

• You suspect you or someone else has sepsis — do not wait for a routine appointment; go to your nearest emergency department or call your local emergency number
• You have a known infection and you are getting worse, not better, despite treatment
• You feel extremely unwell in a way that is hard to explain — trust your instincts
• You notice any of the emergency or urgent symptoms listed above, especially in combination
• A child seems very ill, is unusually sleepy, or is not responding as they normally would
• An older person becomes suddenly confused or much harder to communicate with

Book a routine appointment if:

• After recovering from sepsis, attending all follow-up appointments your healthcare team recommends
• Discussing ongoing symptoms like tiredness, anxiety, or joint pain after a sepsis episode with your GP (family doctor)
• Talking to your doctor about vaccinations and preventive measures if you are in a high-risk group

Diagnosis

There is no single test for sepsis. Doctors diagnose it by looking at the whole picture — your symptoms, physical examination findings, and a range of test results — together. Speed is essential. In hospital, the medical team will assess you quickly using recognised scoring systems (tools that rate how serious your condition might be) while tests are being run at the same time. The NHS uses a tool called NEWS2 (National Early Warning Score 2) to help identify people at risk. Diagnosis is a clinical judgement — meaning your doctors combine all the information they gather to decide whether sepsis is likely and how severe it is.

Tests that may be done

• Blood tests — to check for signs of infection, organ function (how well your kidneys, liver, and other organs are working), clotting (how well your blood can stop bleeding), and markers of inflammation (signs that your body is fighting something)
• Blood culture — a special blood test where a sample is tested to identify which germ is causing the infection
• Urine (wee) tests — to check for a urinary infection
• Imaging scans — such as X-rays, ultrasounds, or CT scans (detailed internal pictures) to find the source of infection
• Swabs — samples taken from wounds, the throat, or other areas to identify the germ
• Lumbar puncture (spinal tap) — if meningitis (brain/spinal cord infection) is suspected; a small sample of fluid from around the spine is tested
• Monitoring of vital signs — continuous checking of your heart rate, blood pressure, breathing rate, temperature, and oxygen levels in the blood

What to expect at your appointment

If sepsis is suspected, things will move quickly. You will likely be admitted to hospital, possibly to a high-dependency or intensive care unit (ICU), where staff can monitor you very closely. Expect to have blood taken, a drip (an intravenous line placed in your vein) set up, and treatment started very rapidly — often within the first hour. This speed is intentional and life-saving. Medical staff will explain what they are doing, but the priority in the first moments is to treat you as fast as possible. Family members or carers will usually be kept informed and supported throughout.

Treatment

Sepsis is always treated in hospital and requires urgent medical intervention. The earlier treatment begins, the better the outcome. Hospitals follow what is called a 'sepsis bundle' or 'sepsis six' — a set of treatments that should all be started as quickly as possible, ideally within the first hour. The NHS and international guidelines emphasise acting fast. Treatment focuses on fighting the infection, supporting the organs that are under stress, and keeping the body's vital functions — like blood pressure, breathing, and kidney function — stable.

Self-care at home

• There is no safe home treatment for sepsis — it always requires hospital care. However, while awaiting emergency help, keep the person as calm and comfortable as possible.
• Do not give food or drink to someone you suspect has sepsis, as they may need surgery or procedures.
• If you are recovering at home after being discharged from hospital, rest is vital — recovery from sepsis can take weeks or months.
• Stay well hydrated by drinking plenty of fluids during recovery, unless your medical team advises otherwise.
• Take any medications exactly as prescribed by your healthcare team during and after hospital treatment.
• Attend all follow-up appointments — post-sepsis recovery needs careful monitoring.
• Reach out for mental health support if you feel anxious, depressed, or are having flashbacks — this is very common after sepsis and is nothing to be ashamed of.

Medical treatments

In hospital, treatment is started immediately and typically involves several things happening at once. Antibiotics (medicines that kill bacteria) or antifungal medicines are given through a drip directly into a vein as soon as possible — timing is critical. Intravenous (IV) fluids are given rapidly to support blood pressure and protect the organs. Oxygen is provided to help the lungs and ensure the body's tissues get enough oxygen. If the blood pressure remains dangerously low despite fluids, medicines to support the heart and blood vessels are given through a drip. In serious cases, organ support may be needed — for example, a breathing machine (ventilator) if the lungs are struggling, or dialysis (a machine that cleans the blood) if the kidneys are not working properly. The source of infection — for example, an abscess (a pocket of pus) or infected tissue — needs to be identified and treated as part of the overall plan.

When is surgery considered?

Surgery may be necessary if the source of infection cannot be treated with medicines alone. Examples include draining an abscess (a painful collection of pus), removing infected tissue, repairing a perforated (ruptured) bowel, or dealing with an infected wound. The decision to operate is made carefully by the medical team, weighing the risks and benefits for each individual person. Surgery, when needed, is an important part of treating sepsis effectively.

Living with this condition

Recovering from sepsis can take a long time — sometimes many months, or even longer. Many survivors find that they are not 'back to normal' as quickly as they hoped, and this can be frustrating. It is important to be patient and kind to yourself. Post-sepsis syndrome is a recognised condition affecting many survivors. It can cause fatigue (extreme tiredness), muscle weakness, difficulty concentrating (sometimes called 'brain fog'), sleep problems, and emotional challenges. These effects are real, not imagined, and your healthcare team can help you manage them. Recovery looks different for everyone — some people recover fully, while others need longer-term support.

Lifestyle tips

• Rest when your body tells you to — pushing through exhaustion can slow recovery
• Gradually increase activity as you get stronger, guided by your healthcare team or a physiotherapist (a specialist in movement and rehabilitation)
• Keep all follow-up medical appointments, as ongoing monitoring helps catch any complications early
• Tell your doctor about any new or worsening symptoms during recovery — do not dismiss them
• Avoid alcohol and smoking during recovery, as both can slow the body's healing process
• Try to maintain a regular daily routine, as structure can help with both physical and mental recovery
• Ask for help from family, friends, or community services — you do not have to manage alone

Diet and exercise

Good nutrition is an important part of recovery. Your body uses a lot of energy to heal, so eating a balanced diet with plenty of protein (found in meat, fish, eggs, beans, and dairy), fruits, vegetables, and whole grains can help. If you have a poor appetite (which is common after a serious illness), try eating smaller, more frequent meals throughout the day. A dietitian (a nutrition specialist) can give you personalised advice if needed. Exercise should be reintroduced very gradually — walking is often a good starting point. A physiotherapist can help you build a safe, step-by-step plan tailored to your needs. Never rush your return to exercise — what matters is slow, steady progress.

Mental health and emotional wellbeing

The emotional impact of sepsis is significant and often underestimated. Survivors frequently experience anxiety, depression, post-traumatic stress disorder (PTSD — a condition where the mind struggles to process a traumatic event), nightmares, and mood changes. These reactions are a normal response to an extremely frightening and physically overwhelming experience. Family members and carers can also be affected. Please do not suffer in silence — talking therapies, counselling, and support from mental health professionals can make a real difference. If you are having thoughts of harming yourself, please contact a crisis support service or your local emergency number immediately. You are not alone, and help is available.

Prevention

While it is not always possible to prevent sepsis entirely, there are meaningful steps you can take to reduce your risk. The key is to prevent infections and to treat them promptly when they do occur. Good hygiene — particularly regular, thorough handwashing — is one of the most effective ways to stop infections spreading. Keep any wounds clean and covered, and see a healthcare provider if a wound becomes red, warm, swollen, or starts to produce discharge (pus), as these are signs of infection. If you have a long-term health condition, keeping it well managed can lower your risk. Follow your healthcare team's guidance about managing conditions like diabetes carefully.

Vaccines

Staying up to date with recommended vaccinations (vaccines that protect against specific infections) is an important way to reduce sepsis risk. Several vaccines help prevent infections that can lead to sepsis, including those for influenza (flu), pneumococcal disease (a type of bacterial infection that can cause pneumonia and meningitis), meningitis, and COVID-19. Vaccination recommendations vary by country and individual health circumstances. Talk to your GP or pharmacist about which vaccines are recommended for you and your family, including all routine childhood immunisations. Vaccination is one of the most powerful tools we have to prevent serious infections.

Screening programmes

There is currently no routine population-wide screening programme specifically for sepsis. However, in hospital and healthcare settings, early warning systems (such as NEWS2 in the NHS) are used to identify patients who may be deteriorating and at risk of developing sepsis. If you are admitted to hospital, staff will regularly monitor your vital signs to catch any early warning signs quickly. After recovering from sepsis, follow-up appointments help monitor your health and identify any complications early.

Complications

If left untreated

• Septic shock — a dangerous drop in blood pressure that can deprive vital organs of the oxygen they need to function
• Organ failure — the kidneys, liver, lungs, heart, or brain may stop working properly or fail completely
• Acute respiratory distress syndrome (ARDS) — severe lung failure requiring breathing support from a machine
• Blood clotting problems — sepsis can cause abnormal clotting throughout the body, damaging tissues and organs
• Tissue death (gangrene) — reduced blood flow can cause body tissue to die, sometimes requiring amputation (surgical removal of a limb or digits)
• Death — sepsis is life-threatening, and delay in treatment significantly increases the risk of dying

Long-term outlook

The outlook for sepsis has improved significantly in recent years, thanks to greater awareness, faster diagnosis, and better treatments. Many people who receive prompt, appropriate treatment make a full or very good recovery. Recovery takes time — it is rarely a quick process — but with proper medical care and support, life after sepsis is absolutely possible. Survivors often describe their recovery as a journey, with gradual improvements over weeks and months. If you have been through sepsis, it is important to acknowledge how far you have come and to seek the support you deserve. There is a growing community of sepsis survivors who are living well and who want to help others do the same. Hope is not just possible — it is well-founded.

Find support

International organisations

• Global Sepsis Alliance ↗
• Sepsis Alliance (International Resources) ↗
• World Health Organization — Sepsis Information ↗

Local organisations

• UK Sepsis Trust ↗ · United Kingdom
• NHS — Sepsis Information and Support ↗ · United Kingdom
• Sepsis Australia ↗ · Australia
• Sepsis Canada ↗ · Canada

Helplines

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