Septic shock symptoms: What are the early signs of septic shock?

Overview: What does septic shock feel like?

Septic shock is a life-threatening medical emergency with a high mortality rate. It is the last and most severe stage of sepsis, a severe immune response to infections. People with sepsis feel very sick, run a high fever, and their heart rate and breathing speed up. Every hour counts because symptoms often rapidly worsen. Eventually, blood pressure drops. Eventually, organs don’t function, a condition called severe sepsis. Urination stops, breathing becomes difficult, and the liver can’t filter the blood of toxins. In the final stage, a person enters septic shock. Blood pressure falls catastrophically, decreasing blood flow and oxygen to the body’s organs. People become confused, dizzy, and weak. They may pass out. The extremities might feel warm to the touch at first (“warm shock”) but then become cold (“cold shock”). The body’s vital organs begin to fail. When someone enters septic shock, every minute counts. The mortality rate is very high. Survivors of septic shock have a high mortality rate in the months or years following the crisis. Those who survive longer than two years often have lifelong chronic illnesses or disabilities.

What are the early signs of septic shock?

Septic shock is the last stage of sepsis, a life-threatening condition that can quickly develop into septic shock. The early signs of septic shock, then, are also the early signs of sepsis:

• Fever

• Chills

• Low body temperature

• Fast heartbeats

• Rapid breathing

• Symptoms of low blood pressure such as dizziness, lightheadedness, confusion, and fainting

RELATED: What causes sepsis? Diagnosis, prevention, and treatment

Other septic shock symptoms

Septic shock is the last stage of sepsis, so it has many of the same symptoms as sepsis and severe sepsis, including:

• Fever (temperature > 100.4F)

• Chills

• Low body temperature

• Fast heart rate (pulse > 100)

• Rapid breathing

• Extreme pain

• Symptoms of low blood pressure such as dizziness, lightheadedness, confusion, and fainting

• Symptoms of organ dysfunction or failure such as changes in mental status, seizures, difficulty breathing, hyperventilation, and infrequent or absent urination

• Symptoms of oxygen starvation such as blue skin, clammy skin, hyperventilation, and loss of consciousness

The symptom that distinguishes septic shock from severe sepsis is persistently low blood pressure even after IV fluids and drugs are used to restore normal blood pressure.

Septic shock vs. sepsis symptoms

Septic shock is a later stage of sepsis, so it has many of the same symptoms as sepsis. The distinguishing feature is very low blood pressure that does not improve with IV fluids.

Stages of septic shock: How can I tell which one I have? 

Septic shock is the last and most life-threatening stage of sepsis. People with sepsis can rapidly progress through all the stages of sepsis, sometimes in as little as 12 hours. The three stages of sepsis are:

• Sepsis is an extreme inflammatory response to infection. It has distinguishing symptoms, including fever, chills, racing heartbeats, and rapid breathing. Blood pressure may fall because of leakage in the blood vessels, producing symptoms like confusion or dizziness.

• Severe sepsis occurs when organs become dysfunctional because of oxygen starvation. Severe sepsis is marked by symptoms such as mental changes, decreased urination, lactic acidosis, and hyperventilation.

• Septic shock occurs when blood pressure is very low and does not recover with fluids and medications. This is the stage in which multiple organs in the body fail. Without appropriate treatment, septic shock commonly ends in death.

RELATED: What are normal blood oxygen levels?

When to see a doctor for septic shock symptoms

Go to an emergency room if you have any of the symptoms of sepsis because it can quickly worsen. The longer treatment is delayed, the more likely the crisis will cause complications that create an increased risk of death in the days or months following recovery. Most people who enter septic shock are already in a hospital. If not, the prognosis is poor. 

In an intensive care unit (ICU), the doctors and other healthcare professionals work very quickly and follow specific treatment guidelines. Both treatment and diagnosis happen at the same time to better the patient’s chances of a full recovery. 

The first order of business is to bring blood pressure back to normal. While that’s happening, the team may take blood tests to determine blood cell counts, blood cultures, urine tests, stool tests, skin tests, or sputum samples to identify the pathogen causing the infection, if that hasn’t already been determined. Chest X-rays, CT scans, MRIs, or other medical imaging may be used to locate the infection. Testing continues throughout treatment and recovery.

Complications of septic shock

Even with treatment, septic shock will lead to complications. Some can be serious, including:

• Multiple organ failure

• Respiratory failure

• Kidney failure

• Blood clots

• Amputation

• Death

Once the septic shock crisis has passed, there is still a high probability of death over the next few days as the person is treated in the ICU or hospital. Complications and death can also occur after release from the hospital. One study found that the five-year mortality rate for people treated for septic shock is over 50%.

How to treat septic shock symptoms

Sepsis is a life-threatening medical emergency that is treated in an intensive care unit (ICU) by intensive care healthcare providers. The primary goal of treatment is to reverse hypotension, perfuse vital organs with blood and oxygen, and save the patient’s life. Treatment follows a set of guidelines called early goal-directed therapy (EGDT). EGDT outlines a scheduled set of critical care procedures, including tests, assessments, monitoring, and treatments that include:

• Intravenous fluids

• Antibiotics

• Surgery to remove infected tissues

• Vasopressors (usually norepinephrine) and corticosteroids to raise blood pressure

• Mechanical ventilation or breathing tubes

Living with septic shock 

Septic shock often causes extensive or severe organ damage and injury to the body. People who survive may be severely sick or debilitated. Many will die in the next couple of years following their release. Readmission to a hospital or ICU is common; some live in a skilled nursing facility or need hospice care. Some may have limbs or digits amputated. Many will have other medical conditions, such as post-traumatic stress disorder (PTSD) or post-sepsis syndrome. Even the healthiest survivors may require support when they go home.

There are no easy tips for surviving septic shock. However, a few solid pieces of advice can help with recovery and quality of life:

• Keep all appointments with healthcare professionals and rehabilitation therapists

• Take all medications as prescribed

• Eat a healthy diet—a nutritionist may design an individualized diet plan

• Exercise within abilities— get medical advice from a physician or physical therapist

• Avoid getting infections through frequent handwashing, hand sanitizer use, mash wearing, and avoiding sick people

FAQs about septic shock symptoms

What organs shut down first with septic shock?

Kidney dysfunction and acute kidney injury occur in more than half of all sepsis and septic shock cases. Part of the reason may be the medications or fluids used in sepsis treatment. 

How long does it take for sepsis to turn into septic shock?

Sepsis can result in septic shock in as little as 12 hours after the initial symptoms, but symptoms could develop over days.

Can organs recover from septic shock?

Severe sepsis and septic shock are marked by multiple organ failure, the most serious complication of sepsis. In some cases, this organ failure can be temporary and resolve over time. In other cases, the organs may never completely recover, requiring medical interventions like dialysis or mechanical ventilation. In some cases, organ failure may be extensive enough for people to be placed in hospice care.

What’s next? Additional resources for people with septic shock symptoms

Test and diagnostics

• Sepsis diagnosis and management, American Family Physician

• Septic shock, Sepsis Alliance

• Septic shock, StatPearls

Treatments

• Sepsis and septic shock: guideline-based management, Cleveland Clinic Journal of Medicine

• Sepsis diagnosis and management, American Family Physician

• Sepsis treatments and medications, SingleCare

• Septic shock, StatPearls

• Septic shock: management and outcomes, Cureus

Scientific studies and clinical trials

• Epidemiology of surgical amputation after sepsis, American Journal of Respiratory and Critical Care Medicine

• Long-term mortality and outcome in hospital survivors of septic shock, sepsis, and severe infections: the importance of aftercare, PLOS One

• Timing and causes of death in septic shock, Annals of Intensive Care

More information on related health conditions

• Pneumonia treatments and medications, SingleCare

• UTI treatments and medications, SingleCare