Pyaemia is a particularly severe form of blood poisoning (sepsis) in which the germs transported by the blood flow also infect other organs. The prognosis is generally even worse than that of ordinary sepsis.
What is pyaemia?
Pyaemia is also referred to as a metastatic general infection because masses of pathogens infect other organs via the bloodstream. The pathogens spread through the bloodstream in a similar way to cancer cells in a cancerous tumor. In this sense, pyaemia can be regarded as a particularly severe form of sepsis. See sportingology for Meaning of Hornstein-Knickenberg Syndrome in English.
Even the usual sepsis represents a serious clinical picture. It is characterized by complex systemic inflammatory reactions due to a massive infection with bacteria, bacterial toxins and fungi. In the case of pyaemia, however, pathogens also reach the lungs, heart, spleen, liver, kidneys, joints or brain as part of an embolism-like spread via the blood.
Foci of infection also form there, which in turn can spread and exacerbate the entire disease process. Abscesses form anywhere in the body. A typical example of pyaemia is childbed fever. In childbed fever, various pathogens penetrate the organism via a large wound area in the placenta and cause inflammation in the peritoneum, uterus, intestines and other organs. In this context it should be noted that the discoverer of childbed fever, the Hungarian doctor Ignaz Philipp Semmelweis, died of pyaemia himself in 1865.
Pyaemia is caused by the massive entry of pathogens such as Streptococcus pyogenes, Staphylococcus pyogenes, Staphylococcus aureus or Neisseria into the bloodstream. These spread throughout the organism and cause the symptoms of sepsis, which is accompanied by additional infection of other organs. Thus, in the case of pyaemia, the organism is impaired both by the systemic inflammatory reactions and by the additional infestation of other organs with germs.
In the case of childbed fever, for example, these pathogens penetrate through the cervix, which is open during the birth process. The cervix is a direct connection from the vagina to the uterus. Even with good hygienic conditions, it is easily possible for the pathogens to infect the uterus. However, the weekly flow normally ensures that the germs are transported back.
However, this is not the case if the weekly flow is too weak and the after-pains are too weak. Other forms of pyaemia are also transmitted through wounds. Both the development of sepsis and pyaemia depend on three factors. These factors include the virulence of the germs, the state of the immune system and the nature of the organism’s reaction. It also plays a role where and how the pathogens enter the organism.
They get into the blood immediately via wounds. Organs such as the brain, lungs or abdominal cavity are poorly protected even in the case of harmless infections, so that the germs can spread there quickly. Of course, people with a weakened immune system have a higher risk of contracting sepsis or even pyaemia. When a large number of pathogens enter the bloodstream, however, a strong immune system is often no longer of any help in averting pyaemia.
Symptoms, Ailments & Signs
Like sepsis, pyaemia is characterized by high intermittent fever, increased respiratory rate, severe disturbances of consciousness, diarrhea, nausea, vomiting, chills, high heart rate, very low blood pressure and possibly septic shock. Abscesses form anywhere in the body. If left untreated, pyaemia is always fatal.
Diagnosis & course of disease
When diagnosing, examining the causative pathogen and the origin of the infection is particularly important. Blood cultures are grown to determine the pathogens. A blood count is also required. As part of a blood gas analysis, statements can be made about the gas distribution of carbon dioxide and oxygen as well as the acid-base balance.
Various course parameters must be monitored during pyaemia. These include regular examinations of blood cultures, blood pressure checks, determinations of blood gases, lung function tests and much more.
In the worst case, pyaemia can lead to the death of the affected person. However, this usually only occurs if the disease is not treated. The internal organs are attacked by the pathogens and can thus be irreversibly damaged. The patients suffer from a very high fever due to the pyaemia. The fever does not subside even with the help of medication.
The respiratory rate of those affected is also often disturbed in the case of pyaemia and there are disturbances of consciousness and possibly also a loss of consciousness. In most cases, those affected also suffer from nausea or vomiting. In addition to the fever, shaking occurs and those affected suffer from high blood pressure. Without treatment, pyaemia usually leads to the death of the patient.
Particular complications in the treatment of pyaemia, as a rule, do not arise. The disease can be treated relatively well with the help of antibiotics. The earlier the disease is diagnosed and treated, the better the chances of a complete cure for the patient. In severe cases, organ transplants may be necessary.
Treatment & Therapy
Because pyaemia is an emergency situation, treatment must be started before the pathogens are fully identified. The earlier therapy begins, the greater the chance of survival. A wide range of antibiotics must first be administered in order to reach the entire spectrum of pathogens.
After the resistance test, you can then switch to the specifically adapted antibiotic. The focus of infection must also be surgically rehabilitated. This also applies to the removal of abscesses in other organs. Furthermore, it is necessary to adjust the central venous pressure and the mean arterial pressure through infusions.
Other treatment methods also include the administration of erythrocytes and lung ventilation. Other organ-supporting measures often have to be carried out. Despite the most intensive therapy, more than 30 percent of those affected die.
To prevent pyaemia, the risks of infection should be reduced. It is important for the general strengthening of the immune system to protect against infectious diseases. A healthy lifestyle with a balanced diet, plenty of exercise and little stress is recommended.
Alcohol consumption and smoking should also be restricted. Furthermore, compliance with hygienic standards such as hand washing and disinfection is very important. This applies in particular to contact with seriously ill people. To avoid childbed fever, among other things, births should always take place under medical supervision.
If pyaemia has been successfully treated, good follow-up care is important in order to prevent pyaemia or sepsis (blood poisoning) and subsequent diseases such as organ damage from occurring again. The organs affected by the pyaemia should be examined regularly. Depending on the organ, this is done using imaging methods such as ultrasound, MRT, CT and X-rays.
However, only external organ damage can be detected and the healing of the damage caused by the pyaemia can be monitored. However, organ function should also be monitored, as long-term limitations are possible as a result of pyaemia. This is done by regularly checking the organ values in the blood. If the brain has been affected by pyaemia, long-term consequences often cannot be detected by blood tests.
The emergence of neurological symptoms such as a new type of headache that occurs without an apparent reason, muscle tremors or signs of paralysis can be a late consequence of pyaemia and should be clarified with the attending physician immediately after the first occurrence. Organ damage that has already occurred must also be treated separately after treatment of the pyaemia.
If an inflammatory skin disease is the underlying disease, it must be treated sustainably dermatologically. If such an underlying disease is present, a high standard of hygiene should also be maintained to prevent the spread of bacteria on the skin.