sepsis and fever in elderly

World Sepsis Day and the Elderly

Sepsis is a severe reaction of the body to an infection. Infections that lead to sepsis often start in the lungs, urinary tract, skin or gastrointestinal tract. Without timely treatment, sepsis can quickly lead to tissue damage, organ failure and death. Sepsis is commonly known as blood poisoning, and occurs when the bloodstream is full of bacteria and usually occurs in response to the body trying to fight a severe infection.

This severe infection causes widespread inflammation that over time can slow blood flow and damage diseased organs. Sepsis can be fatal if it progresses to later stages - severe sepsis or septic shock.

Is sepsis contagious?

No, sepsis is not transmitted to other people. However, infection can lead to sepsis and some infections can be passed on to others.

Who is at risk?

  • Adults 65 years or older
  • People with chronic diseases such as diabetes, lung disease, cancer and kidney disease
  • People with weak immune systems
  • People who have recently had a serious illness or hospitalization
  • Survivors of sepsis
  • Children under one year

What are the signs and symptoms?

A patient with sepsis may have one or more of the following symptoms:

  • High heart rate or low blood pressure
  • Fever, chills or a feeling of extreme cold
  • Confusion or lack of concentration
  • Shortness of breath
  • Severe pain or discomfort
  • Inflamed or sweaty skin

To determine if a person really has sepsis, the patient needs to be evaluated by a specialist. If left untreated, sepsis can damage organs, make breathing difficult, cause diarrhea and nausea, and confuse the patient.

How do you get sepsis?

  • Infection of wounds and burns
  • Wounds or burns increase the chance of sepsis. When the skin is torn, foreign bacteria can enter the body. Extensive burns can also damage the immune system. Most of the time, you do not get sepsis when you have a cut or wound. The body can usually repair itself if needed by a doctor

  • Sepsis from MRSA
  • MRSA (methicillin-resistant Staphylococcus aureus) is a staph bacterial infection that is resistant to many types of antibiotics. If left untreated, it can lead to sepsis. When on the skin, MRSA often does not cause serious problems. But if it enters the body through a wound, it can cause sepsis.

What is septic shock?

It is the most severe stage of sepsis, which begins with heart and circulatory failure and lowers blood pressure. Blood flow to all organs slows down and impairs their function. People who become septic in very severe cases, small blood clots form in the arteries and close vital organs.

Finally, they must be admitted to the hospital ICU to receive round-the-clock care.


To diagnose sepsis, it is necessary for the doctor to examine the following items and examine the patient carefully.

  • Fever measurement
  • Heart rate measurement
  • Assess respiratory rate
  • Check the level of concentration and measure the severity of confusion
  • Perform blood tests and, if necessary, urine tests
  • Radiology of the chest or CT scan

Ways of treatment

Early and invasive treatment of sepsis is best. The patient may be admitted to the ICU. Your doctor will prescribe antibiotics to fight the infection. The patient will also receive IV fluids, oxygen, and medication to prevent hypotension and to support their body

After treatment of sepsis

People with sepsis can recover completely, although they are more likely to get it again. Whether or not it has long-term effects depends in part on the patient's age.

Based on the findings, researchers estimate that sepsis may be responsible for many cases of dementia in people 65 and older each year.

Sepsis and the elderly?

The incidence of severe sepsis and septic shock in the elderly is increasing, leading to an increase in intensive care unit (ICU) admissions. The elderly is prone to sepsis due to co-morbidities, frequent and prolonged hospitalizations, decreased immunity, functional limitations, and most of all due to the effects of aging itself. Diagnosis of sepsis in the elderly should be made more careful as aging may increase the risk of sepsis suddenly worsening and turning into severe sepsis and septic shock. Age itself is an independent risk factor for death in elderly patients with severe sepsis, however, many patients respond well to timely and appropriate interventions. In elderly patients with severe sepsis, treatment should not be limited or delayed solely on the basis of a physician's prejudice.

Sepsis is defined as an inflammatory reaction of the body to an infection, of which severe sepsis and septic shock are more severe forms. Despite advances in the management of septic patients, sepsis is still the second leading cause of death in patients in non-coronary ICUs. The incidence and prevalence of sepsis increases with age.

Similar findings on increased sepsis, with the average age of patients with severe sepsis being around 60, have been reported in Eastern studies. Mortality from severe sepsis also increases with age, with the highest mortality rates in the elderly (patients over 85 years of age). Studies in the elderly with sepsis show that severe sepsis and septic shock are more common in the elderly and have a higher mortality rate in the elderly than in the young.

Risk factors

There are several risk factors that predispose older people to increased sepsis:

  • Simultaneous existence of diseases and drugs for the elderly
  • Underlying diseases such as kidney or lung disease
  • The increased risk of sepsis in the elderly can be due to chronic diseases such as cancer, diabetes, obesity and human immunodeficiency virus and others.

All of these are especially important in older patients.

Performance status before acceptance

There are several reasons for poor performance, including:

  1. Muscle atrophy due to inactive lifestyle.
  2. Sarcopenia due to rapid muscle loss
  3. Changes in response to trophic hormones (growth hormones, androgens and estrogens)
  4. Neural changes
  5. Altered cytokine regulation
  6. Changes in protein metabolism
  7. Dietary changes.

Factors affecting the increase in sepsis

  • Malnutrition
  • Malnutrition is also common in the elderly. Factors such as:

    Inactivity, insufficient budget or resources to provide healthy food, mobility and transportation issues, social isolation, functional limitations, poor or limited diets, chronic diseases, dementia, depression, weak teeth, Multidrug, and alcohol or substance abuse

    It can lead to malnutrition in the elderly, which in turn can make their bodies more susceptible to sepsis.

  • Endocrine insufficiency
  • Aging
  • Other risk factors
  • Older people are also at risk for increased attacks by gram-negative microorganisms, which may be resistant to drugs and make older people more susceptible to sepsis. Possible reasons could be staying in a nursing home, frequent hospitalizations, and interventions such as urinary catheterization, poor functional status, or the use of multiple medications.