What is a bacteremia?
One speaks of a bacteremia when bacteria enter the bloodstream. This is different from sepsis (blood poisoning) because although the bacteria can be detected in the bloodstream, the patient does not experience any systemic inflammatory symptoms (high fever, aching limbs, drop in blood pressure, coughing, etc.). Bacteremia occurs more frequently than one might think: The pathogens get into the blood in small quantities, for example through examinations of bacteria-populated body regions (e.g. dental treatment), but are usually quickly eliminated by the defence system. Only when the extent of the bacteremia exceeds the body’s defenses can the bacteremia develop into a dangerous sepsis. Since this can be life-threatening, a possible bacteremia should not be taken lightly, but its cause should be found and eliminated if possible.
Treatment of a bacteremia
If the immune system is intact and the number of pathogens detected in the blood test is not too high, a therapy for bacteremia can often be dispensed with. In this case, it is limited to repeating the blood test after a few days in order to monitor the course of the pathogen count. If, on the other hand, it can be assumed that the body will not manage to eliminate the cause of the bacteremia and eliminate the pathogens on its own, it must be helped. For example, if the bacteremia is caused by a bacterial inflammation of a heart valve (endocarditis), antibiotic therapy appropriate to the pathogen is first initiated. If this does not have a satisfactory effect, surgical replacement of the affected heart valve may have to be considered in order to eliminate the source of the bacteremia permanently.
What are the accompanying symptoms?
By definition, bacteremia does not cause physical symptoms. If symptoms develop in the course of a bacteremia, these should be taken as an indication of a progression of the bacteremia to sepsis (blood poisoning). The first signs of such a development are usually fever and chills.
Even if one would not yet speak of sepsis in the case of a bacteremia with a moderate fever, the physical symptoms should nevertheless be interpreted as an alarm signal and taken seriously, since an insufficiently treated sepsis can have serious or in the worst case even fatal consequences. Fever occurs when the programmed setpoint for the body temperature in the temperature centre of the brain is adjusted in the course of an infection (for example sepsis). The increased body temperature is supposed to limit the vitality of the pathogens and thus support their elimination.
Fever should therefore be regarded per se as a sensible and desirable mechanism of the body’s own defence system, as long as it does not become too strong. If fever occurs in the course of a bacteremia, the body has difficulty eliminating the pathogens in the blood. For this reason, the doctor treating the patient should be informed immediately of the fever that has developed and it should be measured regularly to monitor the temperature.
The doctor can then assess how likely the development of sepsis (blood poisoning) is and whether further therapeutic measures need to be taken. This topic may also be of interest to you: Causes of feverIn order to combat the pathogens, the body’s temperature must be raised. This requires heat to be generated, which is most effectively and quickly achieved by increased muscle trembling, the chills. As a rule, chills only occur during the onset of a fever when the fever develops very rapidly. Shaking is an important alarm signal for the development of sepsis (blood poisoning) and should result in immediate medical consultation.
