Emergency & Acute Care

Sepsis and Septic Shock — Clinical Reference

Last reviewed 2026-06-16 · TruelyserMD Clinical Reference
For Patients & General Readers

Sepsis is a life-threatening condition where your body has an extreme response to an infection. It can happen to anyone with an infection, but it's more common in older adults, very young children, and people with weakened immune systems. Prompt recognition and treatment are crucial because sepsis can quickly lead to organ failure and death.

Clinical Overview

Sepsis is a dysregulated host response to infection, characterized by life-threatening organ dysfunction. Septic shock is a subset of sepsis defined by persistent hypotension requiring vasopressors to maintain mean arterial pressure and having a serum lactate level greater than 2 mmol/L despite adequate fluid resuscitation.

Clinical Presentation

Signs & Symptoms

Symptoms (Patient-Reported)

  • Fever or feeling very cold (chills)
  • Extreme pain or discomfort
  • Shortness of breath
  • Clammy or sweaty skin
  • Confusion or disorientation
  • High heart rate

Signs (Clinician-Observed)

  • Hypotension (SBP < 90 mmHg or a drop of > 40 mmHg from baseline)
  • Tachycardia (> 90 beats per minute)
  • Tachypnea (> 20 breaths per minute)
  • Altered mental status
  • Decreased urine output

Differential Diagnoses

ConditionDistinguishing Feature
AnaphylaxisRapid onset of symptoms following exposure to an allergen, often with urticaria and angioedema, and typically responsive to epinephrine.
Cardiogenic ShockEvidence of primary cardiac dysfunction (e.g., myocardial infarction, severe heart failure) with elevated jugular venous pressure and often pulmonary edema.
Hypovolemic ShockHistory of significant fluid loss (e.g., hemorrhage, dehydration, burns) with dry mucous membranes and absent bowel sounds.
Neurogenic ShockAssociated with spinal cord injury, resulting in hypotension and bradycardia with warm, dry skin below the level of injury.
Adrenal CrisisCan present with hypotension and shock, but often associated with hyponatremia, hyperkalemia, and eosinophilia, and a history of adrenal insufficiency or steroid use.
Pulmonary EmbolismSudden onset dyspnea and pleuritic chest pain, with risk factors for VTE, and can lead to obstructive shock.

Red Flags — Seek Immediate Care

Key Investigations

Management Overview

Management of sepsis and septic shock is time-sensitive and involves prompt administration of broad-spectrum antibiotics, aggressive fluid resuscitation with crystalloids, and vasopressors to maintain adequate mean arterial pressure. Source control of infection, if identified, is also a critical component of treatment.

Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. TruelyserMD does not replace clinical judgement.