Editing Sepsis (section)

== Signs and symptoms ==
In addition to symptoms related to the actual cause, people with sepsis may have a [[fever]], [[hypothermia|low body temperature]], [[Tachypnea|rapid breathing]], [[tachycardia|a fast heart rate]], [[mental confusion|confusion]], and [[edema]].<ref name="pmid12682500"/> Early signs include a rapid heart rate, [[oliguria|decreased urination]], and high blood sugar. Signs of established sepsis include confusion, [[metabolic acidosis]] (which may be accompanied by a faster breathing rate that leads to [[respiratory alkalosis]]), low blood pressure due to decreased systemic [[vascular resistance]], higher [[cardiac output]], and [[disseminated intravascular coagulation|disorders in blood-clotting]] that may lead to organ failure.<ref name=Hospital2012/> Fever is the most common presenting symptom in sepsis, but fever may be absent in some people such as the elderly or those who are immunocompromised.<ref name="Gauer et al" />

The drop in blood pressure seen in sepsis can cause [[lightheadedness]] and is part of the criteria for [[septic shock]].<ref name=MedLP/>

Oxidative stress is observed in septic shock, with circulating levels of copper and vitamin C being decreased.<ref>{{cite journal | vauthors = Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten AR, Oczkowski S, Szczeklik W, Bischoff SC | display-authors = 6 | title = ESPEN guideline on clinical nutrition in the intensive care unit | journal = Clinical Nutrition | volume = 38 | issue = 1 | pages = 48–79 | date = February 2019 | pmid = 30348463 | doi = 10.1016/j.clnu.2018.08.037 | s2cid = 53036546 | doi-access = free }}</ref>

[[Diastolic blood pressure]] falls during the early stages of sepsis, causing a widening/increasing of [[pulse pressure]], which is the difference between the systolic and diastolic blood pressures. If sepsis becomes severe and [[hemodynamic]] compromise advances, the [[systolic pressure]] also decreases, causing a narrowing/decreasing of pulse pressure.<ref name=pedsepsis>{{cite journal |vauthors=Khilnani P, Singhi S, Lodha R, Santhanam I, Sachdev A, Chugh K, Jaishree M, Ranjit S, Ramachandran B, Ali U, Udani S, Uttam R, Deopujari S |date=January 2010 |title=Pediatric Sepsis Guidelines: Summary for resource-limited countries |journal=Indian J Crit Care Med |volume=14 |issue=1 |pages=41–52 |doi=10.4103/0972-5229.63029 |pmc=2888329 |pmid=20606908 |doi-access=free }}</ref> A pulse pressure of over 70 mmHg in patients with sepsis is correlated with an increased chance of survival.<ref name=widesepsis/> A widened pulse pressure is also correlated with an increased chance that someone with sepsis will benefit from and respond to [[Fluid replacement#Intravenous|IV fluids]].<ref name=widesepsis>{{cite journal |vauthors=Al-Khalisy H, Nikiforov I, Jhajj M, Kodali N, Cheriyath P |date=11 December 2015 |title=A widened pulse pressure: a potential valuable prognostic indicator of mortality in patients with sepsis. J Community Hosp Intern Med Perspect |journal=J Community Hosp Intern Med Perspect |volume=5 |issue=6 |page=29426 |doi=10.3402/jchimp.v5.29426 |pmc=4677588 |pmid=26653692 }}</ref>