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Sepsis and the Death of Muhammad Ali: Learn the Warning Signs

September is Sepsis Awareness Month. Have you heard of this potentially deadly infection?

On June 3, 2016, boxing legend Muhammad Ali died from septic shock at the age of 74. Despite the fact that sepsis strikes nearly 750,000 Americans every year and kills an estimated 28 to 50 blood culturepercent of those who suffer from it, many people have never heard of sepsis or septic shock. However, in the same way that Ali advocated for greater awareness about Parkinson’s disease, his battle with sepsis has the potential to increase our understanding of this deadly infection.

What is Sepsis?

Jeannine Gerolamo, Safety/Quality Specialist at The Center for Patient Safety and Healthcare Quality at Abington-Jefferson Health, describes sepsis as “a life-threatening condition that arises when the body's response to an infection injures its own tissues and organs." This immune system overreaction can lead to widespread inflammation and blood clotting with severe and lifelong consequences, even death. Unfortunately, sepsis moves fast. If not treated quickly, it can lead to severe sepsis and septic shock.

During severe sepsis, the body’s response interferes with the normal functions of vital organs like the heart, lungs, liver and kidneys. When severe sepsis becomes the type of septic shock that Muhammad Ali experienced, it produces a dangerous drop in blood pressure that prevents these vital organs from receiving oxygen. In addition, if a surgical incision on a limb becomes infected and leads to sepsis, it can result in amputation.

“Sepsis is just as serious as a heart attack or stroke,” Gerolamo warns. “It’s an emergency that requires immediate care from a medical provider.”

Who Gets Sepsis?

Anyone can get sepsis, but some people are more likely than others to develop it. Muhammad Ali’s advanced age, chronic illness and recent hospitalizations are among the most common risk factors.

“It most commonly affects the very old and very young. People who are immune compromised, have wounds or injuries, serious comorbidity (like diabetes and heart failure) and invasive medical devices may also be more likely to experience sepsis,” advises Gerolamo.

Additionally, diseases like pneumonia and hospital-acquired infections like MRSA and C. diff make someone more likely to experience sepsis. While it’s unknown exactly what led Ali to develop septic shock, he was hospitalized at the time of his death for respiratory problems that may have been complicated by his Parkinson’s disease.

What Are the Signs and Symptoms of Sepsis?

Sepsis is a syndrome and not a disease, so it’s unlikely that a patient will seek treatment for sepsis itself. However, Gerolamo advises that “signs like changes in mental status, acute confusion, very high or low body temperature and rapid heart rate should always prompt you to seek medical care. This is especially true if you have had a recent hospitalization."

The most prominent symptoms of sepsis are:

  • Decreased urine output
  • Fast heart rate
  • Fever
  • Hypothermia (very low body temperature)
  • Shaking
  • Chills
  • Warm skin or a skin rash
  • Confusion or delirium
  • Hyperventilation (rapid breathing)

How is Sepsis Treated?

“The very best treatment for sepsis is early detection,” says Gerolamo. “However, for patients with sepsis, the standard treatment has remained unchanged for years. It includes aggressive IV fluid therapy, broad spectrum antibiotics, and blood cultures to help with diagnosis.”

The broad spectrum antibiotics that a patient with sepsis will receive should begin immediately, within the first six hours. These are designed to treat a variety of bacteria, and will be administered intravenously. As blood tests return, the doctor may narrow down the antibiotic treatment to fight the specific bacteria causing the infection.

If the patient’s blood pressure is low, they may also receive a vasopressor – a medication designed to increase blood pressure by constricting blood vessels. In cases of severe sepsis and septic shock, a patient may need machines to help them breathe and, if their kidneys fail, dialysis treatment.

How is Sepsis Prevented?

Preventive measures can help to reduce the risk factors for developing sepsis. These measures include getting vaccinated against the flu, pneumonia, meningitis and any other infections that could lead to sepsis. Additionally, you can prevent infections that lead to sepsis by cleaning wounds and practicing good hygiene, including washing your hands and bathing regularly.

If you smoke, Gerolamo’s advice is simple. “Quit now. Smoking leads to many bad outcomes, including increasing your risk for developing sepsis by compromising your lungs.”

If you think that you may have sepsis, it's important to seek care immediately.

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