When a Patient is Admitted for Sepsis: A Personal Journey

When a patient is admitted for sepsis, the course of action can vary significantly depending on the severity and the patient's initial presentation. This personal account highlights the experiences of one patient named Rachel, who was battling a life-threatening infection and the complexities of diagnosing and treating sepsis.

The Early Stages of Illness

Rachel's journey started with persistent pain on her right side. She is a long-term sufferer of Post-Polio Syndrome (PPS), a condition that affects individuals who have survived polio. In the past, Rachel had received steroid and ketamine injections in her right hip, and the right hip pain often radiated up her back. Despite her usual ability to manage this pain, this evening, the discomfort seemed unusually severe. Rachel noticed that she was much colder than usual, a symptom she could attribute to PPS, but then she began to feel hotter, leading to a fever of 106 degrees Fahrenheit. This high fever was concerning, as it did not match the usual symptoms of flu or another viral infection.

The Emergency Department Admission

Rachel initially thought her body's fever was therapeutic, a natural defense mechanism against harmful microorganisms. However, as her condition worsened, she couldn't stand and became incontinent. She knew that she needed help, and though her usual instinct was to rely on her own body to fight the infection, she realized she needed assistance. Rachel pounded on a billy club next to her bed to wake her daughter, who then called 911. Realizing the seriousness of the situation, her daughter insisted on seeking medical help despite Rachel's opposition.

The Diagnosis and Treatment

At the hospital, Rachel was admitted to the Emergency Department. She could not provide any relevant medical history due to her delirium, and the medical team had to proceed with aggressive treatment. They started her on intravenous (IV) antibiotics and antivirals, hooked her up to monitoring devices, and applied a cooling blanket to manage her high temperature. Although Rachel initially refused the cooling blanket, she later found it oddly comforting.

Several tests were conducted, including blood cultures, cerebrospinal fluid (CSF) culture, and an abdominal-pelvic CAT scan. Initially, the blood cultures were negative, and the cerebrospinal fluid and urine tests also showed no signs of infections. However, after further testing, it was discovered that Rachel had a massive right kidney stone that had blocked her kidney, leading to a severe infection that had entered her bloodstream, causing sepsis.

The Life-Threatening Condition and Emergency Response

The diagnosis of sepsis, despite the negative tests, was based on the rapid onset of symptoms and Rachel's known health conditions. The medical team switched antibiotics rapidly, aiming to manage the infection and sepsis. Despite the treatment, Rachel's fever did not significantly reduce, and she exhibited signs of multiple organ failure and pneumonia. She was in the hospital for seven weeks and suffered multiple organ failures that required intensive care.

Once the kidney stone was addressed and treated with lithotripsy, Rachel continued to receive IV antibiotics through a PICC (peripherally inserted central catheter) line. Over the course of a month, she gradually recovered, learning to live with new appreciation for life and a greater respect for her health.

The Impact and Conclusion

Three years later, Rachel reflects on the night she almost lost her life. She is forever grateful to the dedicated ED staff who recognized sepsis and the skilled hospital staff who fought tirelessly to save her. Her daughter, despite her initial defiance, also played a crucial role in ensuring Rachel received the necessary medical attention.

This personal journey emphasizes the critical importance of recognizing and treating sepsis, even when immediate diagnostic tests show negative results. It underscores the need for rapid intervention and the continuous vigilance of healthcare providers.

Post-Polio Syndrome (PPS) is often associated with the long-term effects of polio, leading to a variety of symptoms including pain, muscle weakness, and fatigue, which can complicate the diagnosis of other illnesses.

A billy club is a personal defense tool that can be used to signal for help during emergencies.

The Emergency Department (ED) provides urgent medical care and response to life-threatening situations.

Lithotripsy is a non-invasive procedure that uses high-frequency sound waves to break up kidney stones.

This narrative serves as a reminder of the importance of early recognition, appropriate treatment, and the significant role of the Emergency Department in managing life-threatening conditions such as sepsis.