Sepsis is a life-threatening medical emergency that arises when the body’s response to an infection causes injury to its own tissues and organs. It can progress rapidly, leading to organ failure and death if not treated promptly. Chemotherapy, a common cancer treatment, can increase an individual’s susceptibility to sepsis, making awareness and early recognition important.
How Chemotherapy Increases Sepsis Risk
Chemotherapy targets rapidly dividing cells, including cancer cells. This process also affects healthy fast-growing cells, like those in bone marrow that produce blood cells. This effect, myelosuppression, often leads to a decrease in infection-fighting white blood cells, especially neutrophils, a condition called neutropenia.
Reduced neutrophils weaken the immune system, making it less capable of combating infections. Even minor infections, easily managed by a healthy immune system, can become serious and life-threatening in neutropenic patients. Sepsis risk is highest when neutrophil counts are lowest, typically 10 to 14 days after chemotherapy.
Chemotherapy can also damage mucous membranes (mucositis) throughout the body, creating open sores that provide entry points for bacteria into the bloodstream, increasing infection risk. Central venous catheters, often used for chemotherapy, also serve as sites for bacterial entry, contributing to overall infection risk.
Recognizing the Signs of Sepsis
Early identification of sepsis signs is important for chemotherapy patients, as prompt medical attention improves outcomes. Symptoms can be subtle or mimic other conditions, so vigilance is important. Indicators include abnormal temperature and other signs of infection.
Mental decline (confusion, disorientation, difficulty rousing) can be a sign. Other symptoms include extreme pain or discomfort, clammy or sweaty skin, rapid heart rate, and rapid breathing. The acronym “TIME” helps remember these signs:
Temperature (higher or lower than normal)
Infection (signs and symptoms)
Mental decline
Extremely ill (severe pain, discomfort, or shortness of breath)
Do not wait for all symptoms before seeking medical help. Any suspicion of sepsis in a chemotherapy patient warrants immediate contact with the healthcare team or emergency services. Delaying treatment worsens the prognosis, as death risk increases with each hour treatment is delayed.
Strategies for Prevention and Management
Preventing infections reduces sepsis risk in chemotherapy patients. Meticulous hand hygiene, like frequent washing or using alcohol-based sanitizer, is a step. Patients should also avoid close contact with unwell individuals, especially those with contagious illnesses like flu or COVID-19.
Proper care for central venous catheters is important for preventing insertion site infections. Patients should promptly report any infection signs (fever, redness, swelling, pain) to their medical team. Maintaining good oral hygiene helps reduce mucositis and subsequent infection risk. Following all healthcare team instructions regarding diet, activity, and medication is also a measure.
If sepsis is suspected or diagnosed, immediate medical intervention is needed. Treatment involves administering broad-spectrum antibiotics, often within the first hour. Intravenous fluids maintain blood pressure and support organ function. Close monitoring in a hospital, sometimes in an intensive care unit, allows assessment and treatment adjustment.