About sepsis
What is sepsis?
Sepsis is a life-threatening response of the body to an infection. The immune system becomes dysregulated and damages the body's own organs. Sepsis is a medical emergency: the sooner treatment starts, the better the chance of recovery.
On this page you can read how to recognise sepsis, who is at risk, how treatment works and what recovery may involve. Where possible, we show what the Dutch guideline and the international Surviving Sepsis Campaign recommend.
Recognise
Warning signs of sepsis
Sepsis has no single typical symptom. Think of sepsis when someone with an infection (or fever) gets worse quickly and has one or more of these signs:
Could this be sepsis?
- Confused, drowsy or hard to wake
- Fast or laboured breathing
- Fast heart rate or low blood pressure
- Cold, grey, pale or mottled skin
- Passing little or no urine
- Severe shivering, or a low temperature
- A feeling of "I have never felt this ill"
- In children also: floppy, drowsy, not drinking, or parents worried that the child is not their usual self
In doubt? Call your GP or out-of-hours GP service straight away and use the word sepsis. If someone is severely short of breath, unconscious or confused: call 112.
After seeing a doctor: if you get worse, new signs appear or you do not improve as expected, get back in touch. Older people and people with a weakened immune system may have no fever; confusion can then be the first sign.
What it is
What happens in the body?
In an infection, bacteria, viruses, fungi or parasites enter the body. Usually the immune system clears them. In sepsis this immune response goes awry: blood vessels leak and dilate, blood pressure falls, blood clotting is disturbed and cells use oxygen less well. As a result, organs such as the kidneys, lungs, brain and heart work less well.
International definition Sepsis-3, 2016
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the most severe form: blood pressure stays too low despite adequate intravenous fluids, drugs (vasopressors) are needed and blood lactate is raised.
Singer, JAMA 2016. For children, the Phoenix criteria apply since 2024 Phoenix, JAMA 2024.
Sepsis or blood poisoning? In everyday Dutch, sepsis is often called blood poisoning. That is confusing: not every patient with sepsis has the pathogen in the bloodstream, and an inflamed lymph vessel is also called blood poisoning. Sepsis is the correct term. The infection can start anywhere, for example in the lungs, urinary tract, abdomen or skin. Viruses such as influenza and the coronavirus can also cause sepsis.
Figures
How common is sepsis?
Risk
Who is at higher risk?
Anyone can get sepsis, including healthy young people. The risk of sepsis and of a severe course is higher in:
Age
- People aged 70 and over
- Newborns, especially preterm babies
Weakened immunity
- Chemotherapy or immunosuppressive drugs such as prednisone
- After an organ transplant
- No (functioning) spleen
Illness and care
- Chronic heart, lung or kidney disease, diabetes or liver cirrhosis
- Recent hospital admission or surgery
- Urinary catheter, intravenous line or other foreign material
- Heavy alcohol use
Sepsis increasingly occurs as a complication of chronic diseases such as stroke, COPD and cirrhosis GBD, Lancet Glob Health 2025. Vaccination, good wound care and prompt treatment of infections help prevent sepsis.
In healthcare
How do healthcare professionals recognise sepsis?
No single test proves sepsis. Clinicians combine the story of the patient and relatives with physical examination and measurement of vital signs: breathing, oxygen saturation, blood pressure, heart rate, temperature and consciousness. From these they calculate an early warning score. Blood tests, cultures and imaging show how severe the illness is and where the infection is located.
Dutch sepsis guideline module Early recognition
Combine two questions. When infection is suspected: screen for vital threat with the MEWS or NEWS. When a patient is vitally threatened: consider whether an infection may be the cause. Always ask the signal question "Could this be sepsis?" Do not use the qSOFA score for early recognition.
Summarised from the Dutch sepsis guideline, module Early recognition
Surviving Sepsis Campaign 2026 strong recommendation
In acutely ill hospitalised patients, use NEWS, NEWS2, MEWS or SIRS rather than qSOFA as a single screening tool.
Summarised from the SSC adult guidelines 2026
Dutch sepsis guideline module Biomarkers
Use CRP to make infection more or less likely. Presepsin, IL-6 and procalcitonin add little to the diagnosis and are more expensive.
Summarised from the Dutch sepsis guideline, module Biomarkers
Treatment
How is sepsis treated?
Sepsis is treated as an emergency. Treatment has three tracks that run in parallel: fighting the infection, supporting circulation and oxygen delivery, and supporting the organs until they recover.
1. Fight the infection
Blood cultures are taken and intravenous antibiotics are started as soon as possible. At the same time, the source of infection is tackled: an abscess or inflamed gallbladder is drained or operated on, an infected line is removed. After a few days, antibiotics are adjusted based on the culture results.
2. Restore circulation
Intravenous fluids and, if blood pressure stays low, drugs that tighten the blood vessels (vasopressors). Lactate levels help guide treatment.
3. Support the organs
Oxygen or mechanical ventilation, sometimes dialysis, close monitoring and early mobilisation. In septic shock this takes place in intensive care.
What do the guidelines say?
Surviving Sepsis Campaign 2026 recommendation
For probable or definite sepsis, and for (possible) septic shock, give antimicrobials immediately, ideally within 1 hour of recognition. For possible sepsis without shock: a short course of rapid investigation first and, if concern persists, antimicrobials within 3 hours. Take blood cultures before the first dose.
Summarised from the SSC adult guidelines 2026
Dutch sepsis guideline module Fluid therapy
Start with at least 30 mL/kg (ideal body weight) of crystalloid in the first three hours and evaluate the effect within an hour. Measure lactate as soon as possible and repeat until it normalises (below 2.0 mmol/L). Use crystalloids, not albumin or other colloids; consider balanced solutions.
Summarised from the modules Guiding fluid therapy and Type of resuscitation fluid
Dutch sepsis guideline module Vasopressors
If blood pressure stays low after fluids, start norepinephrine as first choice. Add vasopressin only for hypotension that responds insufficiently.
Summarised from the Dutch sepsis guideline, module Vasopressors
Surviving Sepsis Campaign 2026 recommendation
In septic shock, target an initial mean arterial pressure of 65 mmHg; in patients aged 65 and over, 60 to 65 mmHg is sufficient. After a loading dose, give beta-lactam antibiotics as a prolonged infusion rather than a short bolus.
Summarised from the SSC adult guidelines 2026
Antibiotic choice follows the SWAB guideline on empirical therapy for sepsis. This information is background only and does not replace medical advice.
Children
Sepsis in children
Sepsis in children is often recognised later: children compensate for a long time, and signs such as drowsiness, poor drinking or fast breathing resemble an ordinary infection. Parents noticing that their child is not their usual self is therefore an important warning sign.
New definition Phoenix criteria, 2024
Since 2024, children have an international definition aligned with that for adults: sepsis is infection with life-threatening dysfunction of breathing, circulation, coagulation or the nervous system. Children meeting these criteria had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings.
Dutch guideline Sepsis in children 2021
Consider a paediatric early warning score (Dutch PEWS) for hospitalised children that includes parental concern (the "worried sign"). In septic shock give fluid boluses of 10 mL/kg guided by circulation, and in consultation with the paediatric ICU consider early dilute norepinephrine through a peripheral line.
Summarised from the Dutch guideline Sepsis in children
Surviving Sepsis Campaign children 2026
Measure lactate in probable sepsis. In (suspected) septic shock start antimicrobials as soon as possible, ideally within 1 hour; in probable sepsis without shock after brief targeted investigation, ideally within 3 hours. Use balanced crystalloids rather than normal saline, and after stabilisation titrate oxygen to a conservative target.
Summarised from the SSC children's guidelines 2026
Recovery
After sepsis
Sepsis does not end at discharge. Of people admitted to hospital with sepsis, roughly half recover within the first year; about one in six still has severe physical or cognitive impairment after a year, and many are readmitted Prescott, JAMA 2018. Fatigue, muscle weakness, problems with concentration and memory, anxiety and low mood are common. This is also known as post-sepsis syndrome.
Frequently asked questions
Questions about sepsis
Is sepsis the same as blood poisoning?
No. Blood poisoning is a popular name, but it is misleading. In sepsis the body reacts so strongly to an infection that organs are damaged. Bacteria do not have to be present in the blood.
Is sepsis contagious?
Sepsis itself is not contagious. The infection that leads to sepsis, such as influenza, pneumonia or gastroenteritis, can be.
When should I call a doctor?
Call the GP or out-of-hours GP service immediately if someone with an infection gets worse quickly and is confused, breathes fast, has cold or mottled skin, passes little urine or feels sicker than ever before. Mention the word sepsis. In case of severe breathlessness, unconsciousness or confusion: call 112.
Which infections can lead to sepsis?
Any infection can lead to sepsis. The most common sources are pneumonia, urinary tract infections, abdominal infections and skin or wound infections. Usually bacteria are involved, but viruses such as influenza or COVID-19 and fungi can also cause sepsis.
Can sepsis be prevented?
Not always, but the risk can be reduced: get vaccinated as advised (for example against influenza and pneumococci), keep wounds clean, wash your hands and contact your doctor again if an infection does not improve or gets worse.
How long does recovery from sepsis take?
This varies greatly. Some people recover within weeks, others have symptoms such as fatigue, concentration problems, muscle weakness or anxiety for months to years. This is also called post-sepsis syndrome. Read more on the Aftercare page.
Can you get sepsis more than once?
Yes. After sepsis, the risk of a new infection and a new episode of sepsis is increased, especially in the first year. Stay alert to warning signs.
Glossary
Terms explained
Sepsis
Life-threatening organ dysfunction caused by a dysregulated host response to infection.
Septic shock
The most severe form of sepsis: persistent low blood pressure requiring drugs, with raised lactate despite adequate fluids.
Blood poisoning
A popular name for sepsis, but inaccurate: in sepsis the pathogen is not always in the blood. Sepsis is the preferred term.
Lactate
A substance in the blood that rises when tissues receive or use too little oxygen. Used to assess severity and guide treatment.
MEWS, NEWS2 and PEWS
Early warning scores based on vital signs (breathing, oxygen, blood pressure, heart rate, temperature, consciousness). PEWS is the paediatric version.
qSOFA and SOFA
SOFA measures organ failure and is used to establish sepsis. qSOFA is a shortened version; it is not recommended as a single screening tool.
Vasopressors
Drugs that tighten blood vessels and so raise blood pressure, such as norepinephrine.
Post-sepsis syndrome
Physical, cognitive and psychological problems that may persist for months to years after sepsis.