All about septicaemia

Freedom fighter Dr Nagnath Nayakwadi is fighting the dreaded septicaemia in which your defence mechanisms go into overdrive leading to multiple organ shutdown While running, as 19-year-old Dr Nagnath Nayakwadi turned to take aim at the British soldiers a bullet came and struck him on the chest above the heart. The year was 1941; he and his four companions were fleeing into the forest after looting a British government treasury van. The bullet did not pierce his chest and dropped after hitting him. He was just out of range. Now, at 90, the Padmabhushan Krativeer awardee, better known as Anna Saheb, got lucky a second time when he fought off the life threatening septicaemia disease. He has survived despite multiple organ failure. What is septicaemia? The human blood is a sterile environment where foreign bodies and bacteria do not thrive. However, when the body is infected due to an illness such as that of the abdomen, lungs, kidneys, bones, or of other regions, a weakened immune system may fail to curb the bacteria escaping into the blood stream. According to Dr Conrad Rui Vas, head of ICCU at Lilavati Hospital, septicaemia is the complication of another infection that spreads to the entire body through the blood stream with presence of large amounts of bacteria. Anybody at any age can develop septicaemia. People with a weakened immune system, such as older people, children recovering from an existing illness and those suffering from HIV/AIDS and cancer are at high risk. The onset In case of Anna Saheb, the cause was a urinary tract infection. Urine is considered sterile, but in certain circumstances, bacteria that live in the colon move into the urethra causing an infection. While he was being treated at a hospital at Miraj, Maharashtra, in September last year, doctors thought that he will be cured soon. But low mobility and minimal physical activity at his age took a toll on his immune system. The bacteria that had spread to his urinary tract now progressed to his kidneys causing low urine output and high fever. Further complications started showing in a month's time when the infection spread to his lungs shutting them down. With bacteria spreading in the respiratory and urinary system, his body went into overactive Systemic Inflammatory Response, which results in swelling and inflammation throughout the body. The response occurs as a defence mechanism - blood is increased to the affected areas so that nutrient-laden fluids and white blood cells can heal the damage. But in Anna Saheb's 'overactive' state, this response continued for longer than usual, shutting down his organs one by one. As his lungs failed, he was put on a ventilator and flown to Mumbai. Back to life Inflammation of the body activated another defence mechanism, known as Disseminated Intravascular Coagulation (DIC) which formed small blood clots inside his blood vessels to clot excess blood. The increased clotting used up a large number of blood platelets. With fewer platelets, Anna Saheb suffered from lower gastrointestinal and cerebral bleeding. Blood clots were blocking oxygenated blood from flowing into the heart and other organs and there was a risk of permanent organ damage. There was a 60 per cent chance that he would have not survived. "Had he not been brought in on time, the results could have been disastrous," says Dr Vas. "Early diagnosis is very important to stop the condition from becoming irreversible. And the best way to reverse it is to target the source of bacteria in the body." With a team of doctors Vas determined that the urinary tract was the source of infection. Anna Saheb was administered strong antibiotics to kill the bacteria. "If you target the source and take out the infectious bacteria, all other symptoms start disappearing gradually," he says. The antibiotics were backed-up by inotropic drugs which boosted the heart beats and stabilised blood pressure, thus resulting in more oxygen rich blood reaching the organs. Blood components were introduced in the body to correct the clotting ability due to previously diminished platelets. Anna Saheb has been on treatment for over three months, is still in the ICU but is recovering fast and the doctors have saved his liver, kidneys and heart.