7 Warning Signs of Sepsis

When to suspect sepsis

Adults age 65 and older are 13 times more likely to be hospitalized with sepsis than younger adults, studies show.

If you’ve had any kind of recent infection and you aren’t feeling like yourself, you should ask your health care provider if sepsis could be the cause, doctors said.

You’re at higher risk for sepsis if you have a weakened immune system or a chronic condition such as diabetes, kidney disease or lung disease.

You should also be vigilant if you’ve been in the hospital recently, because some sepsis cases are caused by infections like staph or E. coli you can pick up in a health care setting. A 2020 study published in Intensive Care Medicine found that about 24 percent of sepsis patients had a hospital-acquired infection. It’s also important to be wary at home or in the community, as nearly 87 percent of cases start before a patient goes to the hospital, according to the Centers for Disease Control.

Sepsis warning signs

Because sepsis is hard to detect, seek out medical care if you or a loved one has any of the following symptoms:

1. Extreme pain or discomfort (often at the infection site)

“The way sepsis works, there are often symptoms related to the site of infection within the body,” Self says.

If sepsis is triggered by a gastrointestinal infection, for instance, you may experience severe abdominal pain along with vomiting or diarrhea. Lung infections usually cause shortness of breath and chest pain, while a skin infection can cause a red, warm and painful rash.  

2. Lethargy or tiredness

Sleepiness is common in sepsis patients, especially older adults. You may have less energy or just not feel like yourself.

Pay attention if fatigue causes someone you care about to miss a regular activity like going to church, Winther says: “A very common thing I hear is, ‘Mom normally gets up early. I went over there, and she didn’t want to get out of bed.’ ”

3. Confusion or dizziness

Low blood flow to the brain causes some patients with sepsis to feel extremely light-headed or dizzy. Others, especially those in long-term care, may experience a sudden change in mental status, or confusion.

“For patients who live in assisted living and skilled nursing facilities, it can be something as simple as not interacting with caregivers as much as normal,” Self says. “For people who are verbal and usually carry on conversations, it’s usually obvious when someone is saying things that don’t make sense or seem forgetful.”

4.  Fever, shivering and chills

A high temperature is the classic sign that your immune system is fighting an infection, and it’s also a common early sign of sepsis. You may also experience shivering or feel very cold.

However, you can’t rule out sepsis just because you don’t have a fever, Winther says. Some adults over age 65 and those with weakened immune systems don’t run a temperature, he says.

5.  A very low body temperature

A body temperature under 96 degrees (hypothermia) can also be a sepsis symptom, although it’s not as common. Studies show that hypothermia is associated with a more serious case of sepsis and a higher risk of death.

6.  Fast heart rate, fast breathing or breathlessness

When your body is overreacting in sepsis, it needs more oxygen, so your heart and breathing rate rise. Although it can be difficult for patients to detect those symptoms in themselves, a caregiver may notice fast breathing, Self says.

7.  Clammy, sweaty or blotchy skin

With blood being diverted away from the skin to important organs, your skin may feel clammy and look pale, blue or blotchy. On darker skin, blueness may be easier to see on the palms of the hands or the soles of the feet.

Some people with sepsis develop a cluster of tiny blood spots that look like pinpricks in the skin. If untreated, these gradually get bigger and begin to look like bruises.

The good news is, many hospitals now have protocols or systems to help doctors recognize the signs of sepsis, and sepsis death rates have dropped.

Gibbons said his doctors in the ER suspected sepsis right away. He ultimately spent six days in the hospital, getting antibiotics and fluids intravenously. The lesson, he says, is to seek treatment when you know something isn’t right. “My doctor told me if I had not come in when I did, this might be a different story. It might be my obituary,” he said.