April 6, 2026, 4:03 pm | Read time: 7 minutes
Sepsis is a life-threatening immune system overreaction to an infection. Intensive care physician Prof. Dr. med. Michael Bauer has treated thousands of cases at the University Hospital Jena. He says: He sees far too many patients only after organ failure has already occurred–then a “domino effect” sets in, often ending in death. Therefore, everyone should know the three key symptoms of sepsis.
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Sepsis (blood poisoning) is one of the most common causes of death in Germany–and the leading cause of death in intensive care units. The exact numbers are hard to pin down. Estimates range from around 230,000 to 300,000 cases per year. “There is a large gray area here,” says Prof. Dr. med. Michael Bauer, director of the clinic at the University Hospital Jena and board member of the Center for Sepsis and Sepsis Sequelae. “Often, the death certificate does not list sepsis, but the underlying infection.” The intensive care physician has treated more than 4,000 sepsis cases–about 430 per year. What is known quite precisely: 85,000 people die annually in German intensive care units from sepsis.
“We often see patients only after organ failure has already occurred”
The number of sepsis cases is increasing overall in Germany.1 According to the expert, one reason is demographic change: People are getting older and thus more susceptible to severe infections. At the same time, medical advances also play a role, such as therapies that weaken the immune system and increase the risk of infections, according to Bauer. The extremely dangerous aspect: The disease is often recognized too late.
The biggest problem with sepsis: Many people are unaware of how time-critical the disease is. “We often see patients only after organ failure has already occurred,” says Prof. Bauer. The chances of survival then drop rapidly.
In case of suspected sepsis, every minute counts. What is crucial is how early and consistently action is taken. According to Bauer, it is essential to know the three key symptoms of the disease.
The 3 Key Symptoms of Sepsis
The three most important key symptoms of sepsis are:
- Acute change in mental status (e.g., confusion, disorientation)
- Shortness of breath (more than 20 breaths per minute)
- Low blood pressure (“upper value” below 100 mmHg)
According to Bauer, a sudden onset of confusion, a key symptom, is often misjudged or not taken seriously. Yet it is a warning signal: In case of doubt, call emergency services immediately. Additionally, more nonspecific symptoms can occur, which are easily mistaken for the flu.
Other Possible Signs of Sepsis
- Fever or unusually low body temperature
- Chills
- Severe fatigue and extreme feeling of illness
- Mottled skin
- Noticeable paleness
- Drowsiness
A combination of these symptoms often appears–what is crucial is that the condition deteriorates rapidly.
Common Misconception: The “Red Streak”
According to the intensive care specialist, the well-known red streak on the skin that slowly spreads is not a symptom of sepsis. Instead, it is a result of lymphangitis–a rare inflammation of the lymphatic vessels of the skin and subcutaneous tissue. Lymphangitis is colloquially and mistakenly often referred to as blood poisoning. However, like all severe infections, it can develop into sepsis.
Sepsis in Babies: What Parents Should Watch For
In newborns and infants, the symptoms are often nonspecific. It is all the more important to watch for changes early. Warning signs can include:
Blotchy, pale skin and cold limbs
Noticeable fatigue, apathy, or difficulty waking
Weakness in drinking or loss of appetite
Rapid heartbeat or fast, labored breathing
Fever–or also unusually low body temperature
The combination is crucial: If a baby suddenly appears significantly changed or increasingly weak, it should always be medically evaluated. When in doubt, it’s better to act too early than too late.
What Happens in the Body
The term sepsis comes from Greek and means fermentation or decay. It is the result of numerous infectious diseases that can arise from both external wounds and internal inflammations. Blood poisoning occurs when…
- …the body is unable to control the infection and the immune system responds too weakly–or
- …the immune system’s response is too strong and even harms the body itself.
“As a result, shock, multiple organ failure, and even death can occur,” says intensive care physician Michael Bauer to FITBOOK.
Causes: What Can Trigger Sepsis
The World Health Organization primarily names pneumococci, the bacterium Haemophilus influenzae responsible for bronchitis, and salmonella as common causes of sepsis.2 But seasonal and notifiable viruses such as swine flu, yellow fever, or Ebola viruses are also listed.
Bauer also cites lung, skin tissue, and peritoneal inflammations, as well as urinary tract infections, as other common triggers. “Cancer patients, whose immune systems are severely weakened by chemotherapy, for example, ultimately die from sepsis in the case of a more frequent infection,” says Bauer.
The Precursor That Can Still Be Treated Well
“There is no mild or less dangerous form of sepsis,” says Bauer. Unpleasant infections are the precursor that can still be treated well. Once it is officially considered sepsis–and thus organ function impairment is assumed–one should immediately see a doctor. The doctor then combats the infection source–for example, with antibiotics for pneumonia or even surgery for appendicitis, explains the expert.
Also interesting: Causes and symptoms of food poisoning
Mortality Rate 40 Percent in Septic Shock
If a sepsis patient’s blood pressure drops so low that their organs are no longer adequately supplied with oxygen, it is called septic shock. The chance of survival drops drastically; according to Prof. Bauer, about 40 percent of cases result in death.
How Sepsis Is Treated in the Hospital
In case of suspected sepsis, every minute counts. Treatment begins immediately–often before all test results are available. The first crucial measures include determining the lactate level in the blood–it indicates whether the tissue is already poorly perfused and is considered an important marker for impending septic shock. The pathogen is also identified through the blood.
Therapy starts immediately in parallel. Within the first hour, the patient receives broad-spectrum antibiotics. Infusions stabilize their circulation. If necessary, medications to increase blood pressure are administered.
Also interesting: New sepsis test could save thousands of lives
Survival Chances–Organs in Unstable Circulation Like “Falling Dominoes”
“Many patients respond quickly to this early treatment. However, what is crucial is how early and consistently action is taken,” says the intensive care physician. “You have to imagine it like falling dominoes: If the circulation remains unstable for more than about an hour, more and more organs are affected.”
The faster the therapy begins, the higher the chances of survival–and the lower the risk of lasting damage. Physicians refer to the “Golden Hour of Shock”–the critical first 60 minutes.
What Happens After Surviving Sepsis?
Surviving sepsis does not automatically mean being fully healthy again. “Many affected individuals carry an increased risk for further severe infections–and even for another sepsis,” says Bauer. One reason: The disease often affects people whose immune systems are already weakened. And this risk profile does not simply disappear after acute treatment.
Those who have already had sepsis have a significantly higher risk of contracting it again. “I repeatedly see patients with repeated sepsis episodes–often triggered by different infections,” says the physician. After surviving sepsis, special attention is needed–both for possible long-term effects and for new infections.
Causes and Symptoms of Food Poisoning
Signs that indicate a tetanus infection
Who Is Particularly at Risk
Infants under one year and older people aged 70 or 75 and above are disproportionately affected by sepsis. Genetic factors also play a role. Studies show that the risk can be increased if close family members died early from sepsis. Bauer: “Those who have cases in their family where people under 50 died from sepsis have a sixfold increased risk.”
What Can Be Done Preventively?
According to the physician, members of these three risk groups should adhere to high hygiene standards and get preventive vaccinations, such as against flu or pneumococci. “Vaccination is completely underestimated and particularly important,” the intensive care physician notes.
In particularly vulnerable stages, such as during chemotherapy, large crowds should also be avoided due to the high risk of infection. Wounds should also be closely monitored. Redness, swelling, pain, and delayed healing are warning signs.