The following symptoms and complaints may indicate sepsis (blood poisoning):
Leading symptoms
- Fever (> 38 °Celsius) and chills; less commonly hypothermia (hypothermia, < 36 °Celsius).
- Confusion/drowsiness
- Tachypnea (rapid breathing): > 20/min.
- Blood pressure drop: systolic blood pressure [mmHg] ≤ 100
- Tachycardia (heartbeat too fast: > 100 beats per minute).
- Peripheral inferior blood flow
- Alteration of consciousness (confusion)
- Severe feeling of illness
Possible accompanying symptoms
- Rapid-onset skin hemorrhages in Waterhouse-Friderichsen syndrome such as: Petechiae (pinpoint hemorrhages), sugillations (area hemorrhages), or generalized purpura (as a dermatologic manifestation of thrombocytopenia/platelet deficiency) → think of: Meningococcal sepsis
Warning signs (red flags)
- Responds only when approached/painful stimulus or no response.
- Acute state of confusion
- Tachypnea (respiratory rate ≥ 25/min)
- Requires oxygen to maintain oxygen saturation (SpO2) ≥ 92.
- Systolic blood pressure [mmHg] ≤ 90
- Mean arterial blood pressure [mmHg] < 65 or use of vasopressors.
- Heart rate ≥ 130 beats per minute
- Skin rash or skin lesions Skin lesions: Purpura (spontaneous, small-spot skin, subcutaneous, or mucosal hemorrhages) and/or petechiae (flea-like hemorrhages); rash that cannot be squeezed away; pale skin/cyanosis (blue discoloration of the skin)* .
- Anuria (lack of urine output; maximum 100 ml/24 h) or oliguria (maximum daily output of 500 ml) or urine < 0.5 ml/kg per hour
- Serum lactate ≥ 2 2 mmol/l
- Recent chemotherapy
* In hyperdynamic septic shock, the skin is hyperthermic and usually dry.
