When you get sick—with the flu, a stomach bug or even pneumonia—you expect to start feeling a little better each day. But sometimes the body can react unexpectedly to an infection, leading you to get worse instead of better.

Sepsis is a life-threatening response to an infection in the body. Any infection, even a minor one, can lead to sepsis. In fact, several of the influenza deaths reported in the news this past flu season were actually the result of patients acquiring sepsis.

One of the biggest challenges in diagnosing and treating sepsis is a lack of understanding about what it is, and what the warning signs are. Arming yourself with the knowledge of what to look for is a good place to start.

Suspect Sepsis

We don’t fully understand why, but sometimes the body mounts an unexpected and extreme response to a common infection like food poisoning, a cut or scrape, or a urinary tract infection, says Jeffrey McCue, a physician assistant in Johns Hopkins Bayview’s emergency department. Because they begin with an ordinary infection, many sepsis patients delay seeking treatment until they are very sick, and end up in the emergency department.

Sepsis progresses quickly, and can lead to tissue damage, organ failure or death. The Medical Center has introduced new technology, educated providers and staff, and hired a dedicated sepsis coordinator to help ensure that sepsis cases are detected and treated early.

“We now use technology to help us identify possible sepsis patients early,” says Yamisi Daniel, BSN, RN, Johns Hopkins Bayview’s sepsis coordinator. "Early identification and treatment is the key to fighting sepsis, so people can go back to living their lives.”

Patients and family members can do their part by understanding the symptoms of sepsis:

• Hyperventilation
• Vomiting
• Severe weakness
• Fever
• Confusion or delirium
• Chills
• Rapid heartbeat
• Lethargy
• Decreased urination
• Skin rash

Joseph’s Story

In 2016, Joseph Bowens had a full life that didn’t include time to be sick. Bowens, now 30 years old, worked a full-time IT job during the day and moonlighted as a security guard. When he wasn’t working, he was playing and composing classical music, mostly on the piano. So, when he started coming down with something, he tried to work through it. He had a bad headache, chills and fatigue, and briefly blacked out at work. He went to his primary care doctor, who advised him to stay hydrated and rest.

Over the next couple of days, Bowens’ symptoms continued to progress. His fever spiked. “I felt like I was dying,” Bowens says. “I’ll never forget it.”

Eventually, he was no longer able to stand on his own. His parents had to help carry their son to the car, and used a wheelchair to get him into Johns Hopkins Bayview’s emergency department. The care team in the emergency department immediately began ordering tests to try to determine what was making Bowens so sick. His white blood count was through the roof, proof that his immune system was trying to fight off a significant infection. All possibilities were explored, including meningitis, Zika virus and other tropical diseases, since Bowens had recently traveled.

Sepsis is often difficult to diagnose because its symptoms mimic those of other common infections, especially in the early stages. “We don’t want to cry wolf,” says Ed Chen, M.D., a pulmonary and critical care medicine doctor at Johns Hopkins Bayview. “Our job is to make sure that sepsis is considered as a possibility.”

After Bowens was admitted to Johns Hopkins Bayview, his heart rate accelerated, another common symptom of sepsis. His treatment plan included antibiotics and fluids, both standard in the treatment of sepsis. His heart rate came down, and further tests indicated no other heart problems. After a few days of testing, monitoring and treatment, he was cleared to go home.

McCue, who treated Bowens in the emergency department, says that his sepsis was the response to a skin infection that became an abscess. McCue says that Bowens did exactly what he should have done: he went to see his primary care doctor when he was sick, and then came back to the emergency department when he noticed that he was getting worse instead of better.

Bowens’ illness gave him a new perspective on life. Now, in addition to his music, he has found a second passion. “I started taking my health very seriously,” he says. “I love going to the gym, lifting weights and challenging myself.” He has also reduced the hours he works, giving himself more time for the things he loves.

Act Fast

Doctors are equipped with sophisticated tests, but each person is their own best judge of when something is wrong, says Dr. Chen. “You know how you normally feel on a daily basis,” he says. “If you don’t feel like yourself, especially if you continue to get worse, seek immediate medical attention.” It’s also important to give medical providers as much information as you can. Knowing about the recent scratch from your cat, or the case of food poisoning from your weekend cookout, can help doctors put together the pieces.

Anyone with possible symptoms of sepsis should treat it as a medical emergency. If you have symptoms of an infection that continue to worsen, “think sepsis” and seek immediate medical attention. Swift diagnosis and proper treatment can be the difference between life and death.