What is Septicaemia?
Septicaemia is a serious bloodstream infection caused by various bacteria and sometimes fungi. It can arise from infections in different parts of the body like the lungs, urinary tract, or gut, but sometimes no specific source is found. It is life threatening because it can lead to multiple organ failure and septic shock.
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Causes
Common organisms causing septicaemia include:
- Staphylococcus aureus
- Klebsiella species
- Pseudomonas species
- Staphylococcus epidermidis
- Fungi like Candida species
- Coliform bacteria
- Salmonella species
- Pneumococci
- Proteus species
Risk Factors
- Very young children and elderly people
- Diabetes, cancer, and other conditions causing weak immunity
- Hospital stays
- Community acquired pneumonia
Clinical Features
- Fever
- Extreme tiredness (prostration)
- Low blood pressure (hypotension)
- Anaemia
- Toxic shock (a serious complication)
- Symptoms related to the original infection site, such as cough or urinary symptoms
Differential Diagnosis
- Severe cerebral malaria
- Meningitis
- Typhoid fever (enteric fever)
- Infective endocarditis
Investigations
- Identify possible source of infection and collect appropriate samples
- Blood tests: white blood cell count, blood culture and sensitivity (taken aseptically before starting antibiotics)
Management
General measures:
- Give intravenous fluids
- Control temperature
- Provide nutrition support (e.g., via feeding tube if necessary)
- Monitor vital signs and urine output closely
Treatment:
- Collect blood samples before antibiotics if possible
- If infection focus is known, treat accordingly with intravenous antibiotics
- If focus unknown, start broad coverage:
| Patient | Treatment Regimen |
|---|---|
| Adult | Gentamicin 7 mg/kg IV every 24 hours or 1.5–2 mg/kg IV/IM every 8 hours, plus either: |
| – Cloxacillin 2 g IV every 4–6 hours or | |
| – Chloramphenicol 750 mg IV every 6 hours | |
| Child | Gentamicin 3.5–4 mg/kg IV every 8 hours (neonates: every 8–12 hours), plus either: |
| – Ceftriaxone 50 mg/kg every 8 hours (<7 days old: every 12 hours) or | |
| – Cloxacillin 50 mg/kg IV every 4–6 hours or | |
| – Benzylpenicillin 50,000 IU/kg IV every 4–6 hours |
Prevention
- Protect vulnerable groups such as the immunosuppressed and post-surgical patients
- Strictly follow aseptic techniques during surgery and invasive procedures
