Sepsis: symptoms, causes, treatment and recovery

The NHS says sepsis symptoms can be more difficult to notice in babies and young children, people with dementia, people with a learning disability, and people who have difficulty communicating. A child or adult with sepsis might not have every symptom, so trust your instincts and get immediate help if you think there is something seriously wrong.

The NHS says you need medical help immediately if you think you or your child might have sepsis. Call 999 or go to A&E if any of the following apply. Do not drive yourself to A&E; call 999 or ask someone to drive you.

The UK Sepsis Trust urges people to "Just Ask: Could it be Sepsis?" and says that if you are worried about an infection you should call 111 or contact your GP, and call 999 or go to A&E if someone has one of the sepsis symptoms.

• adult or child aged 5 or over: breathing very fast; confused, slurred speech or not making sense; blue, pale or blotchy skin; a very high or very low temperature, feeling hot or cold to the touch, or shivering; a rash that does not fade when you press it; symptoms you are worried might be sepsis

• baby or child under 5: breathing very fast or having difficulty breathing (grunting noises or tummy sucking under the ribcage); blue, grey, pale or blotchy skin; a rash that does not fade; a temperature of 38C or more in babies under 3 months or 39C or more in babies 3 to 6 months; a temperature under 36C or feeling cold; a weak, high-pitched or continuous cry; not responding normally, not feeding or hard to wake; no pee for 12 hours

NICE Clinical Knowledge Summaries describes sepsis as an overwhelming and life-threatening inflammatory response to a severe infection, which can lead to tissue damage, organ failure and death. The UK Sepsis Trust says it arises when the body's response to infection injures its own tissues and organs, with the immune system going into overdrive. It says there is no single sign or diagnostic test.

The NHS says the exact cause is not known, but the immune system overreacts to an infection and starts to damage the body's organs. Any type of infection can lead to sepsis, but bacterial infections are the most common cause. The UK Sepsis Trust says it always starts with an infection, and it is not known why some people develop sepsis from common infections while others do not.

• chest infections (pneumonia)

• urinary tract infections (UTIs)

• abdominal infections such as appendicitis

• skin infections such as cellulitis or infected wounds

The NHS says anyone can get sepsis, but there is a higher chance if any of the following apply. NICE Clinical Knowledge Summaries lists similar risk factors, including extremes of age, frailty, recent trauma or surgery, and being pregnant, postpartum or having had a recent termination or miscarriage.

• a baby under 12 months old

• being over 75 years

• being pregnant, having given birth, or having had an abortion or miscarriage in the past 6 weeks

• a weakened immune system, for example HIV, sickle cell disease, chemotherapy or taking corticosteroids or immunosuppressants

• a burn, cut or wound, or a skin infection such as cellulitis

• having a catheter

• injecting illegal drugs or misusing alcohol

Sepsis is a reaction of your own body to an infection, so it is not itself passed from person to person. The infection that triggers it, such as a chest infection, may be contagious. The UK Sepsis Trust says sepsis always starts with an infection.

The NHS says sepsis is treated in hospital, and treatment depends on things like age and how unwell you are. Treatment includes antibiotics (a general antibiotic to start with, and then a more specific one after the cause of the infection is confirmed), oxygen to help with breathing, and fluids given into a vein. Sometimes treatment is in a specialist care unit so you can be closely monitored.

NICE Clinical Knowledge Summaries says that people at high risk of severe illness or death from sepsis should usually be transferred urgently to hospital by 999 ambulance.

The NHS says sepsis is a serious condition and it can take weeks or months to recover. It advises being patient, getting enough sleep (7 to 9 hours for adults), eating a balanced diet with smaller, more frequent meals if appetite is reduced, exercising regularly but starting slowly, and keeping a diary of progress.

Post-sepsis syndrome can cause feeling very tired, hearing loss, nerve damage that may cause numbness or weakness in the hands and feet, organ problems, depression, anxiety, loss of confidence, and memory and concentration problems. The NHS says it often lasts 6 to 18 months, though some people take much longer. People who have had sepsis may have a higher chance of other infections, so call NHS 111 if you have had sepsis in the past 12 months and have symptoms of infection such as a very high temperature.

For babies and children the NHS lists specific signs, including temperature thresholds for the youngest babies, and says that a rash that does not fade when pressed is rare in sepsis but may be a symptom of meningitis. See the child section above for the signs that need 999.

The NHS lists being pregnant, having given birth, or having had an abortion or miscarriage in the past 6 weeks as higher risk situations, and NICE Clinical Knowledge Summaries includes women who are pregnant, postpartum, or have recently had a termination or miscarriage among those at higher risk. Anyone in these groups with signs of infection should get urgent help.

Sepsis is an emergency treated through 999, ambulance services and NHS hospitals, which can give antibiotics, oxygen and fluids and monitor in specialist units. Private services are not designed for this emergency, so there is no choice of route to weigh up when sepsis is suspected. After hospital, follow-up for post-sepsis syndrome, such as hearing checks, physiotherapy or counselling, may be arranged through the NHS or privately.