Sepsis in Pakistan: Symptoms, Causes, Treatment and When to Go to Hospital
A person has a chest infection, urine infection or wound infection and suddenly becomes much weaker. The fever is not settling, breathing becomes faster, the person seems confused or sleepy, blood pressure drops, or urine output becomes very low.
These are not symptoms that should simply be watched at home.
An infection can sometimes trigger a serious condition called sepsis. Sepsis happens when the body's response to an infection starts damaging its own tissues and organs. Without timely treatment, it can affect the lungs, kidneys, brain, heart and circulation and may progress to septic shock.
The important point for patients and families is simple: sepsis is not just a bad fever or infection. It is a medical emergency.
What Is Sepsis?
Sepsis occurs when an infection causes an abnormal and harmful response throughout the body.
Normally, the immune system fights an infection in a controlled way. In sepsis, this response becomes uncontrolled and begins affecting normal organ function.
The infection may have started in one part of the body, such as:
Lungs
Urinary tract
Abdomen
Skin or wounds
Gallbladder
Kidneys
Surgical wound
Bloodstream
Bacteria are a common cause, but viral and fungal infections can also lead to sepsis.
This is why someone who originally had what appeared to be a chest infection, UTI or wound infection may later become seriously ill.
Is Sepsis the Same as Blood Infection or Septicaemia?
People in Pakistan commonly use terms such as blood infection, blood poisoning or septicaemia when talking about sepsis.
They are not exactly the same thing.
An infection can enter the bloodstream, but sepsis refers to the body's dangerous response to an infection and the organ problems caused by that response.
A person can therefore develop sepsis even when the infection originally started somewhere else, such as the lungs or urinary tract.
What Are the Early Symptoms of Sepsis?
There is no single symptom that confirms sepsis.
A person with an infection should be assessed urgently if their overall condition is getting worse instead of improving.
Possible warning signs include:
Fever, shivering or feeling unusually cold
Very fast heartbeat
Rapid breathing
Shortness of breath
Severe weakness
Confusion or unusual behaviour
Difficulty staying awake
Severe body pain or discomfort
Cold, clammy or sweaty skin
Low blood pressure
Dizziness or fainting
Reduced urine output
Not every patient develops all of these symptoms.
An elderly patient, for example, may not have a very high fever. Their first noticeable problem may simply be unusual confusion, severe weakness or reduced responsiveness.
When Should a Patient Be Taken to Emergency?
If a person already has an infection and develops difficulty breathing, confusion, unconsciousness, very low blood pressure, severe weakness, reduced urine output or rapid deterioration, do not wait for the next clinic appointment.
They should be taken for urgent medical assessment.
Reliance Hospital's Emergency Patient Department operates for patients requiring urgent and emergency medical care, with diagnostic support available for assessment of critically unwell patients.
It is particularly important not to delay care because the person temporarily feels better after taking fever medicines. Medicines such as paracetamol may reduce the temperature but do not tell you whether the underlying infection is becoming more serious.
What Infections Can Cause Sepsis?
Almost any serious infection can lead to sepsis, but some sources are seen more commonly.
Pneumonia and Chest Infections
Pneumonia can cause severe infection in the lungs. A patient may have:
Fever
Cough
Chest pain
Fast breathing
Falling oxygen levels
Severe shortness of breath
If a chest infection begins affecting oxygen levels, blood pressure or other organs, urgent hospital care may be required.
Patients with persistent or serious respiratory infections can also be assessed through the Pulmonology Department at Reliance Hospital.
Urinary Tract and Kidney Infections
A simple urinary infection usually does not cause sepsis when recognised and treated appropriately. However, an infection that travels upwards towards the kidneys can become serious.
Warning symptoms may include:
Fever with chills
Pain in the back or side
Burning during urination
Vomiting
Severe weakness
Confusion
Reduced urine output
People with kidney disease may already be more vulnerable to complications from serious infections. Reliance Hospital also provides specialist assessment through its Nephrology Department.
Abdominal Infections
Serious infections involving the bowel, appendix, gallbladder, liver or other abdominal organs can also lead to sepsis.
Severe abdominal pain together with fever, vomiting, weakness, low blood pressure or confusion requires medical assessment rather than repeated treatment at home.
Skin, Wound and Surgical Infections
An infected wound may appear increasingly red, swollen, painful or produce discharge.
After surgery, patients should also watch for:
Persistent fever
Increasing pain
Redness around the wound
Pus or unusual discharge
Wound opening
Severe weakness
Rapid deterioration
Most wound infections do not progress to sepsis, but an infection that is spreading should not be ignored.
Who Is More at Risk of Sepsis?
Anyone can develop sepsis, but some people have a higher risk.
These include:
Newborn babies
Older adults
Pregnant women
Women who have recently given birth
People with diabetes
People with chronic kidney disease
Cancer patients
People receiving chemotherapy
People with weakened immune systems
Patients recently admitted to hospital
Patients who recently had major surgery
People with severe burns or large wounds
Patients using urinary catheters, IV lines or breathing tubes
Someone belonging to one of these groups should be assessed earlier if an infection appears to be getting worse.
Can Diabetes Make an Infection More Serious?
Yes.
People with poorly controlled diabetes may have more difficulty fighting certain infections and may also experience slower wound healing.
For Pakistani families caring for a diabetic patient, infections involving the foot, skin, urinary tract or lungs should not be repeatedly managed at home if symptoms are worsening.
A patient may initially need evaluation through General Medicine at Reliance Hospital, while seriously unwell patients may require emergency or critical care depending on their condition.
How Is Sepsis Diagnosed?
There is no single test that by itself answers every case.
Doctors look at the patient's symptoms, medical history, infection source and vital signs while checking whether organs are being affected.
Assessment may include:
Blood pressure
Heart rate
Breathing rate
Oxygen level
Temperature
Urine output
Level of consciousness
Doctors may then request investigations such as:
Complete blood count
Blood cultures
Urine tests and cultures
Kidney function tests
Liver function tests
Blood glucose
Other blood tests depending on the patient's condition
Imaging may also be required to find the infection source. Depending on the case, this can include X-ray, ultrasound or CT imaging.
Reliance Hospital provides Radiology and Imaging Services for diagnostic assessment when imaging is required.
Why Are Blood Cultures Taken?
Blood cultures may help doctors identify bacteria or fungi causing an infection.
This information can help the medical team select more targeted treatment.
However, when doctors strongly suspect serious sepsis, treatment may need to begin before every laboratory result is available. Waiting for all reports before treating a critically ill patient can cause unnecessary delay.
How Is Sepsis Treated?
Treatment depends on the cause of the infection and how severely the patient's organs have been affected.
Antibiotics and Other Antimicrobial Medicines
When bacterial infection is suspected, antibiotics may be required.
The choice of antibiotic depends on the likely source of infection, previous medical history, severity of illness and laboratory results.
Once culture results become available, doctors may adjust the treatment according to the organism identified.
Patients should not start, stop or repeatedly change antibiotics themselves based only on fever or symptoms. Antibiotics that were prescribed to another family member may not be appropriate for the current infection.
IV Fluids
Sepsis can affect blood circulation and cause blood pressure to fall.
Intravenous fluids may be given to improve circulation and maintain blood flow to important organs. The amount required depends on the patient's condition and other medical problems.
Oxygen and Breathing Support
Some patients develop breathing problems because of pneumonia, lung injury or severe infection.
Depending on severity, respiratory support may include:
Supplemental oxygen
High-flow oxygen
Non-invasive breathing support
Mechanical ventilation
A ventilator is not required for every patient with sepsis.
It is generally considered when the patient's breathing has become severely affected or they cannot maintain adequate oxygen levels or protect their airway.
Families who want to understand this process in more detail can read the Reliance Hospital guide on ICU ventilator care and what families should know during an emergency.
Medicines to Support Blood Pressure
In severe sepsis, blood pressure may remain dangerously low even after fluids have been given.
Doctors may then use medicines called vasopressors to help maintain circulation and blood pressure.
Treating the Source of Infection
Treating sepsis also means finding and controlling the original infection.
For example, some patients may require:
Drainage of an abscess
Treatment of an infected wound
Removal or replacement of an infected medical device
Treatment of an abdominal infection
Surgery when an infected source requires surgical control
The exact approach depends on what has caused the infection.
What Is Septic Shock?
Septic shock is a severe form of sepsis in which the patient's circulation and blood pressure become dangerously affected.
At this stage, organs may not receive enough blood and oxygen.
The patient may require:
Continuous monitoring
IV fluids
Blood-pressure supporting medicines
Oxygen
Ventilator support
Kidney support
Management of other failing organs
Septic shock is a life-threatening emergency.
Which Organs Can Sepsis Affect?
Lungs
Sepsis may cause severe breathing difficulty or respiratory failure. Some patients need oxygen or mechanical ventilation.
Kidneys
Blood flow to the kidneys may fall, resulting in acute kidney injury and reduced urine output.
Some critically ill patients may require kidney support or dialysis depending on the severity and cause of kidney failure.
Brain
A patient may become:
Confused
Extremely sleepy
Disoriented
Difficult to wake
Unconscious
A sudden change in mental state during an infection is an important warning sign, particularly in older adults.
Heart and Circulation
Sepsis can cause blood pressure to fall and the heart rate to increase as the body struggles to maintain circulation.
Liver and Other Organs
Severe sepsis can affect several organs at the same time. This is why doctors monitor blood tests, urine output, oxygen levels, blood pressure and other measurements closely.
Does Every Sepsis Patient Need ICU Care?
No.
Some patients can be treated outside the ICU when they are stable and their organs are functioning normally.
ICU admission becomes more likely when the patient develops problems such as:
Severe breathing difficulty
Respiratory failure
Very low blood pressure
Septic shock
Kidney failure
Reduced consciousness
Need for a ventilator
Failure of more than one organ
Need for continuous critical-care monitoring
Reliance Hospital's Intensive Care Unit provides continuous critical-care monitoring, ventilator support and management for patients requiring intensive medical supervision.
Whether a particular patient requires ICU admission can only be decided after clinical assessment.
Can Sepsis Happen During Pregnancy or After Delivery?
Yes.
Infections during pregnancy, after delivery, following a C-section or after pregnancy-related procedures can sometimes become serious.
A woman should receive urgent medical assessment if she develops symptoms such as persistent fever together with severe weakness, confusion, breathing difficulty, worsening abdominal or pelvic pain, very low blood pressure or rapidly worsening health.
Normal post-delivery tiredness should not be used to explain away a woman who appears seriously unwell.
Can Children and Newborn Babies Develop Sepsis?
Yes.
Babies and young children can develop sepsis, and their symptoms may look different from those of adults.
Possible warning signs include:
Very fast breathing
Difficulty feeding
Repeated vomiting
Being unusually sleepy
Difficulty waking
Convulsions
Pale or unusually cold skin
Reduced urination
Weakness or poor responsiveness
Parents should seek urgent medical assessment when a baby or child with an infection looks seriously unwell or is becoming less responsive.
Can Sepsis Be Prevented?
Not every case can be prevented, but many infections that lead to sepsis can be reduced or treated before they become severe.
Useful measures include:
Washing hands properly
Keeping wounds clean and covered
Following safe food and water practices
Receiving recommended vaccinations
Managing diabetes and other chronic illnesses
Seeking treatment when an infection is getting worse
Following proper catheter and wound-care instructions
Taking antibiotics only when medically advised
Completing treatment according to the doctor's instructions
The main aim is not to become frightened by every infection. It is to recognise when an ordinary infection is no longer behaving ordinarily.
A Fever Does Not Automatically Mean Sepsis
Fever is common in Pakistan and may occur with many different infections.
Having a high temperature alone does not mean someone has sepsis.
What matters is the whole condition of the patient.
A person with fever who is drinking, alert, breathing normally and improving is very different from someone with fever who has become confused, breathless, extremely weak, unable to pass urine or has falling blood pressure.
Families should focus on worsening symptoms and the patient's overall condition rather than only the temperature shown on a thermometer.
Frequently Asked Questions About Sepsis
Can a UTI turn into sepsis?
Yes. A urinary tract infection can sometimes spread to the kidneys or bloodstream and lead to sepsis. Fever, chills, back pain, vomiting, confusion or severe weakness with urinary symptoms should be assessed promptly.
Is sepsis contagious?
Sepsis itself is not passed from one person to another. However, the infection that triggered sepsis may sometimes be contagious depending on its cause.
Does every patient with sepsis have a high fever?
No. Some patients may have a high temperature, while others may have a normal or even unusually low temperature. Older adults and people with weak immune systems may not always show the typical fever response.
Is low blood pressure a sign of sepsis?
It can be. Falling blood pressure in a person with a serious infection is concerning, particularly when combined with confusion, rapid breathing, weak pulse or reduced urine output.
Can sepsis occur after surgery?
Yes. An infection developing after surgery can sometimes progress to sepsis. Increasing wound pain, redness, discharge, fever or a sudden deterioration should be reported to the treating team.
Can sepsis occur after childbirth?
Yes. Serious infections can develop during pregnancy or after delivery. Persistent fever with worsening pain, weakness, low blood pressure, breathing difficulty or confusion requires urgent assessment.
Does every sepsis patient need a ventilator?
No. A ventilator is required only when a patient cannot breathe adequately, maintain oxygen levels or safely protect the airway.
Can someone completely recover from sepsis?
Many people do recover, particularly when the infection is identified and treated early. Recovery may take longer after severe sepsis or a prolonged ICU stay, and some patients need rehabilitation and follow-up care.
For patients in Rawalpindi, Islamabad, Bahria Town and nearby areas, Reliance Hospital provides emergency assessment together with medical, diagnostic and critical-care services for patients with serious infections.
Treatment is based on the individual patient's condition. A stable patient may need medical assessment and investigations, while someone developing low blood pressure, respiratory failure, altered consciousness or organ dysfunction may require emergency treatment and ICU monitoring.
Patients requiring critical care can be managed through the hospital's ICU services, with other specialties such as General Medicine, Pulmonology and Nephrology involved according to the patient's medical needs.
If an infection is getting worse and the patient develops difficulty breathing, confusion, fainting, reduced urine output, very low blood pressure or severe deterioration, seek emergency medical care rather than waiting for symptoms to settle on their own.
Early recognition matters because sepsis can become serious in a short period of time.