The patient should have a proven or suspected source of an infection (usually bacterial) and have at least two of the following problems: an elevated heart rate (tachycardia), either a high (fever) or low temperature (hypothermia), rapid breathing (20 breaths per minute or a reduced PaCO2 level), or a white blood cell count that is either high, low, or composed of 10% band cells. In most cases, it is fairly easy to ascertain heart rate (count pulse per minute), fever or hypothermia with a thermometer, and to count breaths per minute even at home. It may be more difficult to prove a source of infection, but if the person has symptoms of infection, such as a productive cough, painful urination, fever, or a wound with pus, it is fairly easy to suspect that a person with an infection may have sepsis. However, determination of the white blood cell count and PaCO2 is usually done by a lab. In most cases, the definitive diagnosis of sepsis is made by a physician in conjunction with laboratory tests.
Some authors consider red lines or red streaks on the skin to be signs of sepsis. However, these streaks are due to local inflammatory changes in either local blood vessels or lymphatic vessels (lymphangitis). The red streaks or lines are worrisome as they usually indicate a spreading infection that can result in sepsis.
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