What is Bacteremia symptoms ?

Bacteremia is the presence of bacteria in the bloodstream. Sepsis is an infection in the bloodstream.


CAUSE
Sepsis is the result of a bacterial infection in the human body.
Which is often a source of sepsis is an infection of the kidney, liver or gall bladder, intestines, skin (cellulitis) and lungs (pneumonia due to bacteria).

Risk factor for sepsis:

Surgery at the infected site or in the body where bacteria normally grow (eg intestine)
Insert foreign objects into the body, such as intravenous catheters, urinary catheters or tubes drainage water
The injected drug abuse
People with immune system disorders (eg due to anti-cancer therapy).


SYMPTOMS
Transient bacteremia that rarely causes symptoms because the body is usually able to eradicate a small number of bacteria immediately.

If there has been sepsis, it will arise the following symptoms:
- Fever or hypothermia (decreased body temperature)
- Hyperventilation
- Chills
- Skin felt warm
- Skin rash
- Tachycardia (increased heart rate)
- Delirious or confused
- Decreased urine production.

If not addressed, sepsis can cause infection throughout the body (metastatic infection). Infection can occur in the lining of the brain (meningitis), in the pericardium (pericarditis), in the heart (endocarditis), in the bone (osteomyelitis) and in the large joints. An abscess (collection of pus) may develop in almost all parts of the body.


Diagnosis
The diagnosis of sepsis infection is suspected when a patient suddenly experienced high fever. The number of white blood cells in the blood is usually very high. Blood culture was made to determine the organism causing the infection. However, the bacteria may not grow in blood cultures, especially if the patient received antibiotic therapy. For samples that need to be cultured from sputum, urine, wound, or from parts of the body where the catheter is inserted.


TREATMENT
Bacteremia due to surgery or catheterization of the urinary tract usually do not require treatment, provided the catheter is removed immediately. But for people at risk for the infection (patients with heart valve disease or immune system deficiencies), before undergoing surgery or catheter, is usually given antibiotics to prevent sepsis.

Sepsis is a serious problem, with a high mortality risk. Antibiotics should be given immediately even before the culture results from the laboratory. At the beginning of antibiotic based on what bacteria are often found in areas that are infected with. 2 types of antibiotics are often given to improve its ability to kill bacteria.

Then if culture results are obtained, antibiotics can be replaced with the most effective for the bacteria that cause infection. In some cases surgery is necessary to eliminate the source of infection, such as an abscess.

May need to be given supportive therapy in the form of supplemental oxygen, intravenous fluids and medications to increase blood pressure. If kidney failure occurs, patients may need dialysis. In the event of respiratory failure, may need to be assisted with a ventilator machine.

What is Septic shock ?

Septic shock is a condition where blood pressure drops to levels that endanger their lives as a result of sepsis.

Septic shock often occurs in:
- The newborn,
- Age over 50 years, and
- People with immune system disorders.


CAUSE
Septic shock caused by toxins produced by certain bacteria and due to cytokines (substances made by the immune system to fight an infection). Toxins released by the bacteria can cause tissue damage and circulatory disorders.

Risk factor for septic shock:

* Chronic disease (diabetes, blood cancer, urinary-genital tract, liver, gall bladder, intestine)
* Infection
* The use of long-term antibiotic
* Medical or surgical measures.


SYMPTOMS
Early signs of septic shock is often a decrease in mental alertness and confusion that arises within 24 hours or more before the blood pressure down. These symptoms occur due to reduced blood flow to the brain. Outpouring of blood from the heart is increased, but blood vessels widen so blood pressure falls. Breathing becomes faster so that the lungs and removing excessive carbon dioxide levels in the blood decreases.

Early symptoms include shivering, body temperature rises very quickly, warm and flushed skin, weak pulse and blood pressure fluctuated. Urine production is reduced despite increased flow of blood from the heart. In later stages, the body temperature often drops to below normal.

When the shock worsened, multiple organ failure:
- Renal: decreased urine production,
- Lung: respiratory distress and decreased oxygen levels in the blood,
- Heart: fluid retention and swelling.

May develop blood clots in the blood vessels.


Diagnosis
Blood tests showed a white blood cell count that much or less and the amount of clotting factors is decreased. If kidney failure occurs, the levels of metabolic waste products (such as urea nitrogen) in the blood will increase. Blood gas analysis showed acidosis and low oxygen concentration.

EKG showed heart rhythm irregularity of the heart, showed inadequate blood supply to the heart muscle. Blood culture was made to determine the bacteria causing the infection.


TREATMENT
At the time of septic shock symptoms arise, the patient immediately put into intensive care room for treatment. Fluids in large quantities given intravenously to raise blood pressure and should be watched closely. Can be given dopamine or nor-epinephrine to shrink blood vessels so that blood pressure rises and blood flow to the brain and the heart increases.

In the event of failure of the lungs, may be required mechanical ventilator. Antibiotics intravenously (through a vein) is given in high doses to kill bacteria. If there are abscesses, pus discharge performed. If the attached catheter that may be the cause of the infection must be removed. May need surgery to remove dead tissue, such as gangrenous tissue of the intestine.