Health

Early Sepsis Warning Signs to Watch

40. Persistent Hiccups Persistent hiccups are an uncommon but notable symptom that can occur in sepsis, signaling underlying neurological or abdominal complications. In the setting of… Diana Yasinskaya - September 3, 2025

Sepsis remains a leading cause of death in the United States, with the Centers for Disease Control and Prevention reporting over 1.7 million cases and at least 350,000 adult deaths annually as of 2024. This life-threatening condition can rapidly affect vital organ systems, including the lungs, kidneys, heart, and brain. Late detection is a major challenge, often resulting in irreversible organ failure and increased mortality. Recognizing the earliest warning signs is crucial for timely intervention and improved patient outcomes.

1. Fever or Abnormally Low Temperature

1. Fever or Abnormally Low Temperature
A concerned patient checks their body temperature with a digital thermometer, revealing a mild fever on the display. | Generated by Google Gemini

One of the earliest signs of sepsis is a significant change in body temperature, which may present as a high fever or, less commonly, an abnormally low temperature (hypothermia). During sepsis, the body’s immune system releases a surge of chemicals into the bloodstream to fight infection. This overwhelming response can disrupt the body’s temperature regulation. A fever occurs as the body attempts to make the environment less hospitable to bacteria or viruses, while hypothermia may develop if the immune system becomes exhausted or the body is unable to mount an effective response, particularly in older adults or those with weakened immunity.

For example, a person with a urinary tract infection that progresses to sepsis might initially experience a fever over 101°F (38.3°C), but in severe cases—especially among the elderly—their temperature can drop below 96.8°F (36°C). Both extremes are alarming and require prompt attention. According to the CDC, sudden temperature changes should never be ignored.

It is vital to monitor temperature closely during any infection. If you or a loved one develop a high fever or become unusually cold, seek medical help immediately, as early intervention can be lifesaving.

2. Rapid Heart Rate

2. Rapid Heart Rate
A digital heart rate monitor displays a steady pulse, highlighting the vital rhythms of the cardiac system in action. | Generated by Google Gemini

A rapid heart rate, or tachycardia, is a common physiological reaction to sepsis. As the infection triggers widespread inflammation, blood vessels may dilate and become more permeable, causing blood pressure to drop. In response, the heart beats faster to maintain adequate blood flow and oxygen delivery to vital organs. This compensatory mechanism is critical, but it also places additional strain on the cardiovascular system.

For instance, a healthy adult typically has a resting heart rate between 60 and 100 beats per minute. In sepsis, it’s not unusual for heart rates to exceed 100, sometimes reaching 120 beats per minute or more, even while at rest. Imagine someone recovering from pneumonia: initially, their heart rate is 80 beats per minute, but as sepsis develops, it climbs rapidly to 110 or higher without exertion. This sudden, unexplained increase is a red flag.

The Sepsis Alliance warns that a persistently elevated heart rate, especially when accompanied by other symptoms of infection, should prompt immediate medical evaluation. Recognizing and acting on changes in heart rate can help identify sepsis early and improve outcomes.

3. Rapid or Labored Breathing

3. Rapid or Labored Breathing
A worried patient clutches their chest as a diagram highlights inflamed lungs, illustrating the struggle of respiratory distress. | Generated by Google Gemini

Sepsis can significantly impact respiratory patterns, often resulting in rapid or labored breathing. As the body responds to infection, metabolic demands increase and tissues may become deprived of oxygen due to poor blood flow or lung involvement. The body compensates by increasing the breathing rate to deliver more oxygen and expel excess carbon dioxide. This is different from the temporary breathlessness experienced after exercise; in sepsis, the breathing changes are persistent, occur at rest, and may worsen over time.

For example, a healthy adult typically takes 12-20 breaths per minute. In sepsis, this rate can rise to over 22 breaths per minute, and breathing may become visibly strained or shallow. The CDC highlights that rapid breathing—particularly when it is not associated with physical activity—can be an early warning sign of sepsis. Individuals may notice increased effort to breathe, shortness of breath while sitting still, or the inability to speak full sentences without gasping.

If you observe rapid or labored breathing in yourself or someone with an infection, do not hesitate to seek prompt medical evaluation. Early recognition of abnormal breathing can be crucial in preventing further complications from sepsis.

4. Confusion or Disorientation

4. Confusion or Disorientation
A concerned doctor explains a brain scan to a confused patient, highlighting areas of interest on the medical chart. | Generated by Google Gemini

Sepsis can quickly impair brain function, leading to sudden confusion, disorientation, or difficulty concentrating. As sepsis progresses, inflammatory chemicals and reduced blood flow can disrupt the brain’s normal operation, depriving it of essential oxygen and nutrients. This condition, often termed septic encephalopathy, is similar to delirium that may arise from dehydration, medication side effects, or metabolic imbalances, but in sepsis, it signals a medical emergency linked to infection.

Unlike the gradual onset of dementia, sepsis-related confusion typically appears rapidly, sometimes within hours. For example, a previously alert individual may suddenly become unable to recognize family members, forget the date, or seem unusually drowsy and inattentive. The Sepsis Alliance emphasizes that any abrupt change in mental status—especially in someone with an existing infection or risk factors—should be taken seriously.

Prompt recognition and action are vital. If you notice new confusion, agitation, or personality changes in someone who might have an infection, seek immediate medical attention. Early intervention can prevent irreversible brain damage and improve survival rates in sepsis. Never dismiss altered mental status as just “old age” or fatigue.

5. Extreme Shivering or Muscle Pain

5. Extreme Shivering or Muscle Pain
A young woman wrapped in a blanket sits on the couch, shivering and clutching her arm in muscle pain. | Generated by Google Gemini

When the body encounters a severe infection, it often responds with intense shivering and widespread muscle pain. These symptoms are triggered by the immune system’s release of chemical messengers called cytokines, which induce fever and drive the muscles to contract rapidly in an effort to raise body temperature. This response is vastly different from the mild chills or aches felt during a typical cold or flu.

A real-life example might involve someone developing a sudden, violent episode of shivering—so strong that they cannot hold a cup or stop their teeth from chattering. They may also experience deep, aching pain in their muscles and joints, making it difficult to move or even rest comfortably. According to the UK National Health Service, these symptoms, especially when accompanied by signs of infection, should be considered a possible early warning of sepsis.

While mild chills and aches can occur with many minor illnesses, extreme shivering or severe muscle pain are red flags that warrant urgent medical evaluation. If these symptoms arise suddenly or are worse than any previous illness, do not dismiss them as a simple viral infection—prompt action could be lifesaving.

6. Clammy or Sweaty Skin

6. Clammy or Sweaty Skin
A close-up of a person wiping their sweaty forehead, their clammy hands highlighting visible skin symptoms of discomfort. | Generated by Google Gemini

Sepsis can cause the skin to become clammy, pale, or excessively sweaty due to profound changes in blood circulation and the body’s stress response. As sepsis progresses, blood vessels may constrict in an attempt to maintain blood pressure, redirecting blood away from the skin to vital organs. This results in skin that feels cold and damp, even in a warm environment. Simultaneously, the body releases stress hormones like adrenaline, which can further increase sweating.

This type of sweating should not be confused with the perspiration experienced during anxiety, exercise, or hot weather. For example, anxiety-related sweating is typically accompanied by a racing heart and feelings of nervousness, but the skin usually remains warm. In sepsis, the combination of cold, clammy skin and sweating without physical exertion is particularly concerning. The Sepsis Alliance highlights clammy or sweaty skin as a key early warning sign.

If you notice unexplained clamminess or excessive sweating—especially alongside other infection symptoms—seek immediate medical care. These changes in skin appearance and texture can signal a severe underlying problem and should never be ignored.

7. Low Blood Pressure

7. Low Blood Pressure
A nurse checks the blood pressure of a pale, lightheaded patient showing classic signs of hypotension. | Generated by Google Gemini

Sepsis can cause blood pressure to drop to dangerously low levels, a condition known as septic shock. This occurs when the immune system’s response to infection triggers widespread inflammation, making blood vessels leaky and reducing their ability to constrict. As a result, blood cannot circulate effectively, depriving organs of oxygen and nutrients. This is similar to other types of shock, such as those caused by severe bleeding or dehydration, but in sepsis, the underlying trigger is infection.

Typical signs of low blood pressure include dizziness, lightheadedness, fainting, or a sense of weakness—especially when standing up. Unlike the temporary dizziness you might feel after standing too quickly, sepsis-induced low blood pressure persists and worsens over time. For example, a person with a urinary tract infection may suddenly become weak and unable to stay upright, or they may collapse unexpectedly.

The CDC stresses that a drop in blood pressure is a critical warning sign of severe sepsis and requires urgent intervention. If you or someone you know develops these symptoms, particularly in the context of an infection, seek emergency medical care without delay.

8. Decreased Urine Output

8. Decreased Urine Output
A person stands in a bathroom, holding a kidney diagram, tracking their urine output with a measuring container. | Generated by Google Gemini

One of the crucial organs affected by sepsis is the kidney. As sepsis progresses, blood flow to the kidneys decreases due to low blood pressure and widespread inflammation. This impairment can cause the kidneys to stop filtering waste efficiently, leading to a notable reduction in urine output. The body’s response to infection and shock prioritizes supplying blood to essential organs like the heart and brain, further limiting kidney function.

For comparison, reduced urination also occurs during dehydration, when the body conserves water by producing less urine. However, in sepsis, the decrease in urine output is not just a sign of fluid loss but a warning of potential kidney injury or failure. For instance, an individual who normally urinates every few hours may suddenly notice they have not needed to urinate for an entire day, or their urine becomes very dark and concentrated.

According to the Sepsis Alliance, monitoring urine output is vital in patients with suspected infection, especially those who are critically ill or hospitalized. If you or someone you care for experiences a dramatic drop in urine production, seek immediate medical attention, as this may indicate severe organ dysfunction due to sepsis.

9. Pale or Mottled Skin

9. Pale or Mottled Skin
Close-up of a hand with pale, mottled skin, highlighting noticeable changes in color and texture. | Generated by Google Gemini

Changes in skin color, such as paleness or mottling, are significant indicators of circulatory problems during sepsis. As the body struggles to maintain blood flow to vital organs, it diverts blood away from the skin and extremities, resulting in skin that appears unusually pale, grayish, or blotchy. Mottled skin often has a patchy or marbled appearance, especially noticeable on the legs, arms, or around the knees.

While skin pallor can also occur in response to cold temperatures—when blood vessels constrict to conserve heat—such changes are usually temporary and resolve once the person is warmed. In contrast, the discoloration seen in sepsis persists, regardless of external temperature, and may worsen as the condition advances. For example, a person with a persistent infection may develop skin that looks ashen or spotted, accompanied by coolness to the touch.

The UK National Health Service (NHS) warns that pale, mottled, or abnormally colored skin in the context of infection should be treated as a medical emergency. If you observe these changes—especially alongside other signs like fever, rapid breathing, or confusion—seek immediate medical help, as early action can be lifesaving.

10. Unexplained Weakness or Fatigue

10. Unexplained Weakness or Fatigue
A tired patient rests on a hospital bed, their face marked by visible fatigue and noticeable weakness. | Generated by Google Gemini

Sepsis places immense stress on the body, resulting in a profound sense of weakness or fatigue that is often far greater than ordinary tiredness. When fighting a severe infection, the immune system consumes large amounts of energy, and the body diverts resources to vital organs, sometimes leaving muscles and other tissues deprived. This energy drain manifests as sudden, overwhelming exhaustion, even after minimal activity or while at rest.

Unlike the tiredness commonly felt after a night of poor sleep or a busy day, sepsis-related fatigue is persistent and does not improve with rest. For example, a person may find themselves unable to get out of bed, walk across a room, or perform basic tasks that were easy just days before. The Sepsis Alliance notes that this marked decline in energy is often among the first symptoms family members notice.

If you or a loved one experiences sudden, severe weakness or exhaustion—especially in the context of an infection or other sepsis symptoms—it is a red flag for possible sepsis. Prompt medical attention is critical, as early treatment can prevent life-threatening complications.

11. Nausea or Vomiting

11. Nausea or Vomiting
A young woman clutches her stomach with a pained expression, sitting beside a bucket after experiencing nausea and vomiting. | Generated by Google Gemini

Sepsis often affects the gastrointestinal system, leading to symptoms such as nausea and vomiting. This occurs as the body’s inflammatory response to infection disrupts normal gut function and diverts blood away from the digestive organs toward the heart and brain. The resulting irritation and reduced oxygen supply can cause the stomach to become unsettled, producing persistent queasiness or bouts of vomiting.

Unlike nausea or vomiting from a typical stomach virus, which generally resolves within a day or two and is often accompanied by diarrhea, sepsis-related gastrointestinal symptoms tend to appear alongside other concerning signs—such as fever, rapid heartbeat, or confusion. For example, someone battling a urinary tract or lung infection may suddenly develop severe nausea and vomiting without any apparent digestive infection.

The Sepsis Alliance highlights that persistent vomiting or inability to keep fluids down, especially if accompanied by other symptoms of infection, requires urgent medical care. Monitor for signs of dehydration and worsening overall condition. If gastrointestinal distress does not improve or is paired with additional sepsis indicators, seek immediate evaluation, as early intervention is essential for survival.

12. Diarrhea

12. Diarrhea
A person sits on a white toilet, clutching their stomach in discomfort, highlighting digestive system distress and diarrhea. | Generated by Google Gemini

Diarrhea can be an early sign that the body is responding to a widespread infection, as sepsis often disrupts normal gastrointestinal function. During sepsis, inflammatory chemicals and reduced blood flow can impair the gut’s ability to absorb fluids properly, leading to frequent, loose, or watery stools. In some cases, the infection itself originates in the digestive tract, but even when it does not, sepsis can trigger systemic inflammation that affects bowel habits.

While diarrhea from foodborne illness typically resolves within a few days and is usually the primary symptom, in sepsis, diarrhea is often accompanied by other warning signs such as fever, confusion, or rapid heart rate. For instance, someone with pneumonia or a urinary tract infection may suddenly develop severe diarrhea, which, when coupled with other symptoms, should raise concern for a more systemic problem.

The Centers for Disease Control and Prevention (CDC) notes that persistent diarrhea, especially when accompanied by additional signs of sepsis, warrants prompt medical evaluation. If diarrhea is severe, unusual, or occurs alongside symptoms like low blood pressure, confusion, or decreased urine output, it may indicate sepsis and requires immediate attention.

13. Shortness of Breath

13. Shortness of Breath
A person clutching their chest struggles to breathe, with illustrated lungs highlighting the sensation of shortness of breath. | Generated by Google Gemini

Shortness of breath, or difficulty breathing, is a serious symptom that frequently accompanies sepsis. As the body’s organs and tissues struggle to get enough oxygen due to poor circulation and inflammation, the respiratory system works harder to compensate. In severe cases, sepsis may lead to acute respiratory distress syndrome (ARDS), where the lungs are unable to provide sufficient oxygen, compounding the danger.

Unlike an asthma attack, where shortness of breath is usually triggered by allergens and improves with inhalers, sepsis-related breathing difficulties are often sudden and persist despite rest or traditional asthma treatments. For example, a person with a skin or urinary infection may unexpectedly become breathless, unable to catch their breath even while sitting still or speaking. Breathing may be rapid, shallow, or visibly labored.

The Sepsis Alliance stresses that new or worsening shortness of breath in the context of infection demands urgent medical attention. If you or someone you know develops this symptom—especially if it is accompanied by other sepsis warning signs—seek immediate care, as rapid intervention can be lifesaving and prevent respiratory failure.

14. Swelling or Edema

14. Swelling or Edema
Legs visibly swollen due to edema, with noticeable fluid retention causing puffiness around the ankles and lower calves. | Generated by Google Gemini

Swelling, or edema, can develop during sepsis as a result of fluid leaking from blood vessels into surrounding tissues. The widespread inflammation caused by sepsis makes blood vessel walls more permeable, allowing plasma and other fluids to escape. This leakage leads to visible swelling, often in the legs, ankles, hands, or face, and can signal that the body’s organs are under severe stress.

Unlike swelling from an injury—such as a sprained ankle, where swelling is localized and directly related to trauma—sepsis-related edema is often more generalized and may appear in multiple areas at once. For instance, someone with sepsis might notice their feet, hands, or even eyelids becoming puffy and tight without any clear cause. This can be accompanied by other signs, such as a decrease in urine output or sudden weight gain due to fluid retention.

The Centers for Disease Control and Prevention (CDC) advises that new or unexplained swelling in the context of infection should not be ignored. If you or a loved one develops unexplained edema—especially with other sepsis symptoms—seek immediate medical evaluation to prevent further complications.

15. Severe Pain or Discomfort

15. Severe Pain or Discomfort
A patient winces and clutches their side, clearly experiencing pain and discomfort in a clinical setting. | Generated by Google Gemini

Intense pain is a common and sometimes overlooked feature of sepsis. As infection spreads and the immune response intensifies, inflammatory chemicals can sensitize nerves throughout the body, leading to widespread or localized pain. This pain is often more severe and diffuse than the discomfort caused by a typical injury, such as a sprain or bruise, and may not be clearly linked to any visible trauma.

For example, while pain from an injury is usually confined to the affected area and tends to improve with rest or over-the-counter medication, sepsis-related pain may be persistent, severe, and resistant to typical pain relievers. It can manifest as deep muscle aches, sharp abdominal pain, or a general sense of overwhelming discomfort. According to the Sepsis Alliance, severe pain or discomfort—especially when it occurs suddenly or is accompanied by fever, confusion, or other warning signs—should never be dismissed.

If you or someone you know experiences new, unexplained, or escalating pain in the presence of infection, consider it a possible sign of sepsis. Prompt medical attention is crucial, as pain may signal underlying tissue damage or organ dysfunction requiring urgent treatment.

16. Bluish Lips or Fingertips

16. Bluish Lips or Fingertips
A close-up view of a person’s face and hands reveals striking blue lips and fingertips, signs of cyanosis. | Generated by Google Gemini

Bluish discoloration of the lips, fingertips, or other extremities—known as cyanosis—is a serious sign that the body is not getting enough oxygen. In sepsis, poor circulation and reduced oxygen delivery to the tissues can cause this alarming change in color. As blood oxygen levels drop, the skin and mucous membranes may take on a blue or grayish tint, especially in areas furthest from the heart.

It’s important to distinguish this from the temporary blue coloring that can occur when hands or feet are exposed to cold weather. Cold-induced cyanosis usually resolves quickly once the person is warmed, and it isn’t associated with other symptoms of illness. In contrast, cyanosis during sepsis is persistent, does not improve with warmth, and is often accompanied by other signs of severe illness, such as rapid breathing or confusion.

The CDC emphasizes that bluish lips or fingertips are a critical warning sign of dangerously low oxygen levels and require immediate medical attention. If you notice these changes—particularly in someone with an infection or other symptoms of sepsis—call emergency services right away, as urgent intervention is vital.

17. Rash or Skin Lesions

17. Rash or Skin Lesions
Red, inflamed skin shows multiple raised lesions clustered together, suggesting the presence of a contagious, infectious rash. | Generated by Google Gemini

Sepsis can trigger the development of rashes or unusual skin lesions as a result of the body’s intense immune response and changes in blood flow. When the infection overwhelms the bloodstream, it can cause small blood vessels to break or become blocked, leading to pinpoint red spots (petechiae), larger purple areas (purpura), or widespread rash. These changes are often due to clotting abnormalities or inflammation within the skin’s small blood vessels.

Unlike common allergic rashes—which tend to be itchy, raised, and resolve with antihistamines—a sepsis-related rash may not itch and can rapidly spread or change in appearance. For example, a person with sepsis may notice a flat, red rash that does not fade when pressed (a warning sign known as a “non-blanching” rash). In severe cases, skin lesions may blister or develop blackened areas, indicating tissue death.

The Sepsis Alliance and NHS advise that any new or rapidly evolving rash, especially if accompanied by fever, confusion, or other sepsis symptoms, should prompt immediate medical evaluation. Timely recognition of these skin changes can be lifesaving.

18. Rapidly Spreading Redness

18. Rapidly Spreading Redness
A close-up view of a leg with pronounced red skin, showing the spreading warmth and inflammation of cellulitis. | Generated by Google Gemini

One of the alarming skin changes that can occur during sepsis is rapidly spreading redness, often resembling cellulitis. As sepsis takes hold, bacteria or toxins may invade the deeper layers of the skin and soft tissue, causing redness, warmth, and swelling that expand quickly. This process results from the immune system’s attempt to contain the infection, which leads to increased blood flow and inflammation in the affected area.

Unlike a localized infection—such as a small abscess or insect bite—where redness remains confined and may resolve with simple wound care, sepsis-related redness spreads over hours rather than days. For example, what starts as a small patch of redness on the leg may extend several inches within a short period, often accompanied by severe pain, fever, or chills. The skin may feel hot and tight, and red streaks may appear, moving up the limb toward the body.

The CDC and NHS urge that rapidly spreading redness, particularly when coupled with other signs of sepsis, should be treated as a medical emergency. Immediate evaluation and treatment are essential to prevent further tissue damage and systemic complications.

19. Unconsciousness or Fainting

19. Unconsciousness or Fainting
Paramedics rush to assist an unconscious patient who has fainted, highlighting the urgency of a medical emergency. | Generated by Google Gemini

Unconsciousness or fainting is a grave warning sign in sepsis, indicating that the brain is not receiving enough oxygen or nutrients due to severely impaired circulation. As sepsis advances, blood pressure can plummet, and the body’s ability to maintain adequate blood flow to the brain becomes compromised. This can cause an individual to suddenly lose consciousness, become unresponsive, or experience a brief fainting episode.

While fainting can also result from less severe causes such as dehydration, standing up too quickly, or missing a meal, these episodes are typically short-lived, and the person usually recovers rapidly upon lying down. In contrast, loss of consciousness during sepsis may occur without warning, is often prolonged, and signals a life-threatening medical emergency. For example, a person with a known infection might collapse, fail to respond to verbal or physical stimuli, or have difficulty waking up after fainting.

The CDC and NHS stress that any sudden loss of consciousness, especially in the context of infection, demands immediate medical intervention. If someone becomes unresponsive, call emergency services right away—early action is essential to improve survival chances.

20. Severe Headache

20. Severe Headache
A woman sits with her eyes closed, pressing her temples in discomfort as a headache intensifies. | Generated by Google Gemini

Sepsis can trigger severe headaches as a result of systemic inflammation, changes in blood pressure, and reduced oxygen delivery to the brain. The immune system’s widespread response to infection can cause blood vessels in the brain to dilate or constrict unpredictably, leading to intense, persistent pain. In more serious cases, sepsis can even cause inflammation of the membranes around the brain, mimicking symptoms of meningitis.

Unlike migraines—which are often preceded by specific triggers, visual auras, or sensitivity to light and sound—headaches associated with sepsis tend to be sudden, intense, and often accompanied by other alarming symptoms such as fever, confusion, neck stiffness, or sensitivity to light. For example, someone with a recent infection who develops a severe, unrelenting headache that does not respond to usual medications should be evaluated urgently.

The Sepsis Alliance and NHS both emphasize that new or worsening severe headaches—especially in the context of infection, altered mental status, or neck pain—require immediate medical assessment. Prompt recognition and treatment are crucial to prevent life-threatening complications related to sepsis and its effects on the brain.

21. Increased Sensitivity to Light

21. Increased Sensitivity to Light
A person shields their eyes from a bright light, visibly uncomfortable due to heightened sensitivity and photophobia. | Generated by Google Gemini

Sepsis can sometimes cause increased sensitivity to light, a symptom medically known as photophobia. This occurs when inflammation from the body’s immune response affects the brain or the tissues surrounding it, such as in cases of meningitis or encephalitis associated with sepsis. The irritation or swelling of these sensitive tissues can make exposure to even normal levels of light uncomfortable or painful for the eyes.

Photophobia is also seen in conditions like migraines, eye infections, or after staring at screens for extended periods. However, when associated with sepsis, it is typically accompanied by additional warning signs, such as fever, headache, neck stiffness, or confusion. For example, a person with a recent infection might suddenly need to avoid lighted rooms or cover their eyes, finding that bright lights make their headaches or general discomfort much worse.

According to the NHS, new or severe light sensitivity in the context of infection should be treated as a medical emergency—especially if it occurs alongside other symptoms like neck pain, altered consciousness, or a severe headache. Immediate evaluation is essential, as this may indicate serious complications requiring urgent intervention.

22. Seizures

22. Seizures
Medical professionals rush to assist a person experiencing a convulsive seizure, providing urgent emergency care on the scene. | Generated by Google Gemini

Seizures can occur as a severe neurological complication of sepsis. The widespread inflammation and infection associated with sepsis can disrupt the normal balance of chemicals and oxygen in the brain, leading to abnormal electrical activity that causes convulsions or loss of consciousness. In some cases, sepsis can lead to encephalitis or meningitis, further increasing the risk of seizures by inflaming the brain or its protective membranes.

Unlike epilepsy, where seizures are chronic and often managed with medication, seizures in sepsis typically appear suddenly in individuals with no prior history of seizure disorders. These episodes may involve full-body shaking, staring spells, sudden loss of awareness, or unresponsiveness. For example, a person with a severe infection who suddenly begins to twitch uncontrollably or loses consciousness should be considered at high risk for sepsis-related complications.

The NHS and Sepsis Alliance stress that any seizure in the context of infection is a medical emergency. Immediate action—calling emergency services and seeking urgent evaluation—is critical, as seizures in sepsis may indicate severe brain involvement and rapidly worsening illness requiring intensive treatment.

23. Dark or Tea-Colored Urine

23. Dark or Tea-Colored Urine
A clear container holds a dark urine sample, highlighting a common warning sign of potential kidney problems. | Generated by Google Gemini

Dark or tea-colored urine is a concerning symptom that can signal kidney dysfunction during sepsis. As sepsis progresses, reduced blood flow and inflammation may impair the kidneys’ ability to filter waste products and maintain fluid balance. This can result in urine that appears much darker than normal—ranging from amber to brown or even tea-colored—often due to the presence of concentrated waste, blood, or muscle breakdown byproducts.

While dehydration can also cause urine to become darker as the body conserves water, the discoloration usually improves with increased fluid intake. In contrast, dark urine in sepsis often persists, even when a person is adequately hydrated, and may be accompanied by other symptoms like reduced urine output, swelling, or confusion. For example, someone with a recent infection who notices their urine turning dark and their urination frequency dropping should be alert to the possibility of acute kidney injury.

The Sepsis Alliance highlights that persistent dark or tea-colored urine—especially when paired with other signs of infection—warrants urgent medical evaluation. This symptom may indicate severe organ involvement and requires prompt intervention to prevent lasting kidney damage or other life-threatening complications.

24. Decreased Platelet Count

24. Decreased Platelet Count
Sepsis-induced inflammation can rapidly decrease platelet count, increasing bleeding risk and potential complications.

Sepsis often leads to a decreased platelet count, or thrombocytopenia, because the body’s inflammatory response can trigger abnormal clotting and excessive consumption of platelets. Platelets are essential for blood clotting, and a significant drop can result in increased risk of bleeding and bruising. During sepsis, the immune system’s overreaction may cause platelets to be used up faster than they are produced, sometimes leading to a dangerous condition known as disseminated intravascular coagulation (DIC).

While low platelets may also be caused by medications, autoimmune diseases, or certain viral infections, the decline in sepsis is usually rapid and occurs alongside other symptoms such as fever, confusion, or visible bruising. For example, a patient with pneumonia who develops unexpected nosebleeds, pinpoint red spots (petechiae), or large bruises with minimal trauma may be experiencing a sepsis-related drop in platelets.

The CDC and Sepsis Alliance recommend seeking a blood test if there are signs of infection with unexplained bleeding or bruising. Early detection of thrombocytopenia is crucial for diagnosing sepsis and preventing potentially life-threatening complications.

25. Bleeding or Bruising Easily

25. Bleeding or Bruising Easily
Purple and yellow bruises with mild bleeding are visible on pale skin, highlighting the effects of recent trauma. | Generated by Google Gemini

Sepsis can seriously disrupt the body’s ability to form clots, leading to increased bleeding or easy bruising. The intense inflammation caused by sepsis may trigger widespread activation of the clotting system, using up platelets and clotting factors and resulting in a condition known as disseminated intravascular coagulation (DIC). As a result, minor bumps can cause large bruises, and even small cuts may bleed longer than usual.

For example, someone with a respiratory infection who suddenly notices dark, spreading bruises on their arms or legs without any clear injury, or who experiences bleeding gums while brushing their teeth, may be experiencing the effects of sepsis on the blood’s clotting ability. These symptoms are unlike the mild bruising that sometimes occurs from everyday activities and should not be dismissed, especially if they develop quickly or are accompanied by other signs of infection.

The Sepsis Alliance and CDC recommend closely monitoring for unexplained bleeding—such as nosebleeds, red or purple spots on the skin, or blood in urine or stool—when infection is present. Seek prompt medical attention, as early intervention can prevent severe complications.

26. Persistent Cough

26. Persistent Cough
A woman covers her mouth with her hand as she coughs, her expression showing discomfort from throat and respiratory symptoms. | Generated by Google Gemini

A persistent cough can be a sign that a respiratory infection has become severe or is spreading, increasing the risk of sepsis. When bacteria or viruses invade the lungs or airways, the body’s immune response may lead to ongoing inflammation and irritation, resulting in a cough that doesn’t resolve as expected. While coughs are common with colds and usually fade within a week or two, a cough that lingers, worsens, or is accompanied by other symptoms may indicate a more serious underlying problem.

Unlike the mild, dry cough associated with most colds, a cough linked to a deeper infection—such as pneumonia—may produce mucus that is green, yellow, or blood-tinged. This type of cough is often accompanied by fever, chest pain, or difficulty breathing. For instance, someone recovering from a cold who develops a new, hacking cough that persists for days and is paired with fatigue or shortness of breath should be evaluated for possible complications.

The CDC suggests tracking the duration, severity, and any changes in a cough, especially in those with risk factors for sepsis. If a cough is persistent and associated with other warning signs, seek medical assessment promptly.

27. Chest Pain

27. Chest Pain
A man clutches his chest with a pained expression, highlighting the sudden discomfort of heart-related chest pain. | Generated by Google Gemini

Chest pain during sepsis can signal involvement of the heart or lungs, both of which are particularly vulnerable to the effects of widespread infection and inflammation. Sepsis may cause the heart muscle to become inflamed (myocarditis), disrupt normal heart rhythms, or lead to reduced oxygen delivery, all of which can result in pain or pressure in the chest. Similarly, severe lung infections such as pneumonia or the development of acute respiratory distress syndrome (ARDS) can cause sharp, stabbing, or persistent chest discomfort.

This pain is different from the fleeting, tight sensation sometimes experienced with anxiety or panic attacks, which usually resolves with relaxation or deep breaths. In sepsis, chest pain often persists, may worsen with breathing or coughing, and is frequently accompanied by other warning signs like rapid heartbeat, shortness of breath, or low blood pressure. For example, a person with a respiratory infection who develops new or worsening chest pain should be evaluated urgently for complications like pneumonia, pleurisy, or cardiac involvement.

The CDC warns that any unexplained chest pain—especially when associated with infection, fever, or difficulty breathing—is a medical emergency. Immediate medical attention can be lifesaving and prevent organ damage.

28. Persistent Hiccups

28. Persistent Hiccups
A patient clutches their abdomen with a pained expression, clearly experiencing discomfort from persistent hiccups and abdominal symptoms. | Generated by Google Gemini

While hiccups are usually harmless and short-lived, persistent or intractable hiccups can be a rare but notable symptom of sepsis. Hiccups are caused by involuntary contractions of the diaphragm, which may be triggered by irritation of the nerves controlling this muscle. In sepsis, persistent hiccups can arise from neurological involvement, such as irritation or inflammation of the brain or nerves, or from abdominal complications like infection of the diaphragm, liver, or stomach lining.

This is quite different from the benign hiccups that follow eating too quickly, drinking carbonated beverages, or laughing, which typically resolve within minutes. In sepsis, hiccups may continue for hours or even days, and are often accompanied by other concerning symptoms such as abdominal pain, fever, confusion, or difficulty breathing. For example, a patient being treated for an abdominal infection who develops unrelenting hiccups and worsening discomfort should be assessed for deeper complications.

The National Institutes of Health (NIH) notes that persistent hiccups in the context of infection should not be ignored, as they may indicate serious neurological or gastrointestinal involvement. If hiccups are continuous and occur with other signs of sepsis, prompt medical evaluation is necessary.

29. Poor Appetite

29. Poor Appetite
A half-eaten meal sits untouched on a plate, as a person gazes at it with little interest. | Generated by Google Gemini

Loss of appetite is a common response to systemic illness, including sepsis. As the body mounts a vigorous immune response, inflammatory cytokines can disrupt the normal signaling between the brain and digestive system, leading to a marked decrease in hunger. Additionally, nausea, altered taste, and fatigue often accompanying sepsis can make eating even less appealing. This is the body’s way of redirecting energy and resources toward fighting the infection, rather than digesting food.

While appetite often decreases during periods of stress or emotional upset, these changes are usually temporary and improve once the stressor resolves. In contrast, poor appetite in sepsis is often abrupt, severe, and persistent. For example, someone with a recent infection might suddenly lose all interest in food, skip multiple meals, and begin to lose weight without trying. This symptom may also be accompanied by other warning signs, such as fever, weakness, or confusion.

The Sepsis Alliance advises that a sudden and unexplained drop in appetite, especially when it occurs with other signs of infection, should prompt medical attention. Persistent loss of appetite can signal that the body is overwhelmed by systemic illness and needs urgent evaluation.

30. Jaundice (Yellowing of Skin/Eyes)

30. Jaundice (Yellowing of Skin/Eyes)
A close-up of a person’s face reveals yellow-tinged eyes, a classic sign of jaundice and impaired liver function. | Generated by Google Gemini

Jaundice, or the yellowing of the skin and eyes, can develop during sepsis when the liver becomes overwhelmed or injured by infection and inflammation. The liver’s primary role is to filter toxins and process bilirubin, a yellow pigment produced during the breakdown of red blood cells. When sepsis impairs liver function, bilirubin accumulates in the bloodstream, eventually depositing in the skin and sclera (whites of the eyes) and causing a distinctive yellow hue.

Jaundice can also occur in conditions like hepatitis, where viral infection directly attacks the liver, but in sepsis, it is typically the result of multi-organ dysfunction and the body’s overwhelming systemic response. For example, a person battling sepsis from a urinary or lung infection may notice their skin and eyes turning yellow, accompanied by dark urine and pale stools. This is a serious sign that the liver is failing to keep up with the demands placed on it by the infection.

The Sepsis Alliance urges immediate medical evaluation if jaundice develops, especially in the setting of other sepsis symptoms. Early recognition and treatment are critical, as liver involvement signals severe, life-threatening progression of the illness.

31. Rapid Deterioration

31. Rapid Deterioration
Doctors rush a patient on a stretcher through a brightly lit hospital corridor, responding to a rapid medical decline. | Generated by Google Gemini

One of the most alarming characteristics of sepsis is the potential for rapid and severe decline in a person’s overall condition. Unlike many infections or illnesses that progress gradually over days or weeks, sepsis can cause critical changes within hours. This sudden deterioration occurs as the body’s response to infection spirals out of control, leading to widespread inflammation, organ dysfunction, and a cascading failure of multiple bodily systems.

For example, someone with a mild fever and cough in the morning may become profoundly weak, confused, and unable to stand by afternoon. This is in stark contrast to the slow worsening seen in most viral illnesses or chronic conditions, where symptoms intensify more gradually. The abrupt onset of multiple new symptoms—such as confusion, low blood pressure, rapid breathing, or reduced urine output—should always be treated as a medical emergency.

The CDC and Sepsis Alliance both emphasize that rapid changes in health, especially against the backdrop of infection, must never be ignored. Seek emergency care immediately, as swift intervention is crucial to prevent irreversible organ damage and improve survival.

32. Persistent High Blood Sugar

32. Persistent High Blood Sugar
Sepsis-induced stress hyperglycemia: elevated blood sugar from hormonal response, risking further complications.

Sepsis can trigger a phenomenon known as stress hyperglycemia, where blood sugar levels remain persistently high even in individuals without a history of diabetes. The body’s severe response to infection causes the release of stress hormones such as cortisol and adrenaline, which increase glucose production and decrease the effectiveness of insulin. This elevation in blood sugar is the body’s attempt to provide extra energy for fighting infection, but it can quickly become harmful if not controlled.

Unlike the steady or predictable blood sugar elevations seen in diabetes, stress hyperglycemia in sepsis often appears suddenly and is resistant to standard measures, such as eating less sugar or taking oral medications. For example, a hospitalized patient with an infection may develop blood glucose readings well above 180 mg/dL, despite having no previous issues with blood sugar control. Persistent high blood sugar in this setting can further impair the immune response and wound healing, increasing the risk of complications.

The National Institutes of Health (NIH) recommends close monitoring of glucose levels in anyone with infection, especially those who are critically ill. Sudden or persistent high blood sugar during illness should prompt discussion with a healthcare provider, as it may be an early warning sign of severe systemic stress like sepsis.

33. Unexplained Anxiety or Restlessness

33. Unexplained Anxiety or Restlessness
A nervous patient sits on the edge of a clinic chair, fidgeting anxiously with their hands. | Generated by Google Gemini

Unexplained anxiety or restlessness can be an early and subtle indication of sepsis, reflecting the body’s response to systemic illness. As sepsis disrupts the balance of oxygen and nutrients reaching the brain, neurological and psychological symptoms may manifest. The body’s release of stress hormones and inflammatory mediators can provoke agitation, confusion, or an uneasy sense of impending doom, even before more obvious physical symptoms develop.

This is distinct from anxiety or restlessness brought on by emotional stress or life events, which often have identifiable triggers and can be managed with relaxation techniques or reassurance. In sepsis, the agitation is persistent and may be accompanied by other concerning changes, such as altered mental status, rapid heart rate, or fever. For instance, a previously calm patient may suddenly appear panicked, repeatedly get out of bed, or become difficult to console without clear cause.

The Sepsis Alliance and CDC stress that new or unexplained behavioral changes in someone with infection should not be ignored. If anxiety or restlessness develops suddenly, especially when paired with other sepsis warning signs, seek immediate medical evaluation to prevent further complications.

34. Persistent Sore Throat

34. Persistent Sore Throat
A doctor gently examines a patient’s open mouth with a tongue depressor, checking for signs of throat infection. | Generated by Google Gemini

A persistent sore throat can be more than just a minor irritation—it may signal a serious infection that, if left untreated, can progress to sepsis. While most sore throats are caused by viruses or mild bacterial infections and resolve within a week, certain pathogens, such as Group A Streptococcus, can invade deeper tissues or enter the bloodstream. When this occurs, the infection may spread rapidly, overwhelming the immune system and triggering a systemic response.

Unlike the scratchy discomfort of a typical viral sore throat, a sore throat related to a more severe infection often persists beyond a week, intensifies in severity, and may be accompanied by other alarming symptoms such as fever, swollen lymph nodes, difficulty swallowing, or visible pus on the tonsils. In rare cases, the infection can lead to the formation of abscesses or cause swelling that threatens the airway—a true medical emergency.

The CDC advises seeking prompt medical attention if a sore throat is severe, does not improve, or is associated with additional symptoms like rash, high fever, or breathing difficulties. Persistent or worsening sore throat, especially in the context of overall illness or infection, should raise suspicion for possible sepsis or serious complications.

35. Red Streaks on Skin

35. Red Streaks on Skin
Bright red streaks travel up an arm, a classic sign of lymphangitis developing from a localized skin infection. | Generated by Google Gemini

Red streaks on the skin, medically known as lymphangitis, often indicate that an infection is spreading through the lymphatic system. These streaks typically appear as thin, red lines extending from the site of an injury, wound, or abscess toward the nearest group of lymph nodes—such as from the hand up the arm or from the foot up the leg. The redness is due to inflammation of the lymphatic vessels as they transport infection-fighting cells, but it can also signal that bacteria or toxins are traveling through the body, raising the risk of sepsis.

Unlike bruises, which are usually blue, purple, or yellow and result from bleeding under the skin due to trauma, lymphangitis presents as distinct, linear red streaks that may be warm and tender to the touch. These streaks can develop quickly and are often accompanied by other signs of infection, such as swelling, pain, fever, or chills. For example, a person with a cut on their leg who notices red lines moving upward should seek medical attention immediately.

The CDC and NHS warn that red streaks on the skin are a sign of a spreading infection and a potential precursor to sepsis. Immediate evaluation and treatment are essential to prevent serious complications.

36. Unusual Smell to Breath

36. Unusual Smell to Breath
A concerned woman discreetly covers her mouth with her hand, worried about noticeable breath odor and halitosis. | Generated by Google Gemini

An unusual or foul smell to the breath can be an unexpected but important warning sign of sepsis. When the body is overwhelmed by infection, metabolic processes may become severely disrupted. Conditions like kidney or liver dysfunction—both common in severe sepsis—can lead to the accumulation of waste products in the blood. This can produce distinct odors, such as an ammonia-like, fruity, or musty smell on the breath, depending on the specific metabolic imbalance involved.

This is different from typical halitosis caused by dental problems, poor oral hygiene, or eating pungent foods, which tends to be mild and easily remedied with brushing or mouthwash. In sepsis, the breath odor is more persistent and pronounced, and it may be accompanied by other symptoms like confusion, jaundice, or reduced urine output. For example, a patient with sepsis-related kidney failure may develop a breath odor often described as “urine-like” due to urea buildup.

The Sepsis Alliance notes that a sudden, unusual breath odor in someone with infection or systemic symptoms should not be ignored. Noticing this sign—especially alongside other changes—can prompt timely medical evaluation and potentially avert life-threatening complications.

37. Difficulty Waking Up

37. Difficulty Waking Up
A weary patient lies motionless on a hospital bed, eyes closed in deep unconsciousness from sheer fatigue. | Generated by Google Gemini

Sepsis can profoundly impair consciousness, making it difficult or even impossible to wake a person. As sepsis advances, poor blood flow and oxygen delivery to the brain disrupt normal mental function, sometimes progressing to stupor or coma. This severe alteration in consciousness is drastically different from the temporary grogginess experienced after a restless night, which typically resolves with time and stimulation.

In sepsis, a person may become unresponsive to voice, touch, or even pain. For example, a loved one who was alert the previous day may suddenly be hard to rouse, not respond to questions, or drift back to sleep immediately after being awakened. This is especially concerning if it occurs alongside other signs of severe infection, such as fever, abnormal breathing, or low blood pressure.

According to the Sepsis Alliance and CDC, difficulty waking up or sudden unresponsiveness in the context of infection is a medical emergency. Immediate intervention is critical to prevent irreversible brain damage or death. If someone is hard to wake, call emergency services without delay.

38. Cool Extremities

38. Cool Extremities
A person sits bundled in a cozy blanket, rubbing their cold hands and feet to boost circulation on a chilly day. | Generated by Google Gemini

Cool extremities, such as cold hands or feet, can be an important sign of poor circulation during sepsis. As sepsis advances, the body redirects blood flow away from the skin and peripheral tissues to prioritize vital organs like the heart, brain, and kidneys. This compensatory response results in hands, feet, and sometimes limbs feeling unusually cool or cold to the touch—even in a warm environment.

Unlike the cold hands or feet experienced during chilly weather, which resolve with warming and do not usually indicate systemic illness, cool extremities in sepsis often persist and may be accompanied by other symptoms such as mottled skin, weak pulses, or decreased urine output. For example, a person with a severe infection may develop cold feet and fingers despite being covered with blankets and having a normal room temperature.

The NHS and Sepsis Alliance warn that new or unexplained coolness in the extremities—especially when occurring alongside fever, confusion, or low blood pressure—should prompt immediate medical evaluation. Regularly checking the temperature and color of the hands and feet in someone with infection can aid in early detection of sepsis and prevent further complications.

39. Slurred Speech

39. Slurred Speech
A concerned woman struggles to express herself, her slurred speech and confusion hinting at possible neurological symptoms. | Generated by Google Gemini

Slurred speech is a neurological symptom that can occur during sepsis, indicating that the brain is not functioning properly due to reduced oxygen delivery, inflammation, or metabolic disturbances. As sepsis affects the central nervous system, communication between the brain and the muscles controlling speech can become impaired, resulting in words that are difficult to understand, slow, or garbled.

This is noticeably different from slurred speech caused by alcohol consumption, which is usually associated with intoxication and resolves as the alcohol wears off. In contrast, slurred speech during sepsis may appear suddenly in someone who was previously speaking normally and is often accompanied by other symptoms, such as confusion, weakness, or altered mental status. For example, a patient with an infection who suddenly starts mumbling or cannot articulate words clearly may be experiencing a serious neurological complication.

The Sepsis Alliance and CDC emphasize that any new or unexplained speech difficulties in the context of infection warrant immediate medical attention. Slurred speech may be an early warning sign of severe sepsis or stroke, and rapid assessment and treatment are vital for the best possible outcome.

40. Persistent Hiccups

40. Persistent Hiccups
Persistent hiccups in sepsis may indicate serious neurological or abdominal complications requiring prompt evaluation.

Persistent hiccups are an uncommon but notable symptom that can occur in sepsis, signaling underlying neurological or abdominal complications. In the setting of sepsis, the diaphragm or the nerves that control it—such as the phrenic or vagus nerves—may become irritated due to inflammation, infection, or metabolic imbalances. Additionally, sepsis can lead to complications like liver or kidney dysfunction, which may further disrupt normal nerve signaling and result in ongoing hiccups.

Benign hiccups, which typically follow eating too quickly, drinking carbonated beverages, or laughing, usually resolve within minutes and are rarely a cause for concern. In contrast, hiccups associated with sepsis are persistent, lasting for hours or even days, and may be resistant to simple remedies. These prolonged episodes are often accompanied by other serious symptoms such as abdominal pain, confusion, or vomiting, highlighting the possibility of systemic or organ involvement.

The National Institutes of Health (NIH) advises that persistent hiccups in a person with signs of infection or other sepsis symptoms should not be ignored. This unusual symptom may be an early indicator of severe illness, and prompt medical evaluation is necessary to identify and treat any underlying complications.

41. Severe Abdominal Pain

41. Severe Abdominal Pain
A person clutches their stomach in distress, wincing from sudden, intense abdominal pain that signals a possible emergency. | Generated by Google Gemini

Severe abdominal pain is a significant warning sign that may indicate sepsis originating from an intra-abdominal infection or the onset of organ failure. Conditions such as peritonitis, appendicitis, or perforated bowel can trigger a widespread inflammatory response, allowing bacteria and toxins to enter the bloodstream and overwhelm the body’s defenses. As sepsis progresses, reduced blood flow and oxygen delivery can further damage abdominal organs, intensifying the pain.

This type of pain is quite different from the discomfort of a mild stomachache caused by indigestion or gas, which typically resolves with time or over-the-counter remedies. In sepsis, abdominal pain is usually severe, persistent, and may be accompanied by other symptoms like vomiting, fever, swelling, tenderness, or a rigid (board-like) abdomen. For example, an individual with a urinary tract or gastrointestinal infection who suddenly develops excruciating abdominal pain should be evaluated urgently for possible sepsis or organ dysfunction.

The CDC and Sepsis Alliance stress that severe or worsening abdominal pain, especially when it occurs alongside other signs of infection, is a medical emergency requiring immediate attention to prevent life-threatening complications.

42. Unexplained Bleeding Gums

42. Unexplained Bleeding Gums
A close-up of a mouth showing bleeding gums, highlighting common symptoms and the importance of good oral health. | Generated by Google Gemini

Unexplained bleeding gums can be a sign of underlying clotting abnormalities that often develop during sepsis. As sepsis progresses, the body’s inflammatory response can trigger widespread activation of the clotting system, which may consume platelets and clotting factors faster than they are produced. This imbalance can lead to spontaneous bleeding from mucous membranes, such as the gums, even without trauma or vigorous brushing.

Bleeding gums are commonly associated with gum disease (gingivitis or periodontitis) or poor oral hygiene, which typically cause localized bleeding during brushing or flossing and improve with better dental care. In contrast, bleeding gums related to sepsis tend to occur suddenly, are more persistent, and are often accompanied by other symptoms like easy bruising, nosebleeds, or pinpoint red spots on the skin. For example, someone with an infection who starts noticing blood in their saliva or on their toothbrush without any known dental issues should be evaluated for possible clotting problems.

The CDC and Sepsis Alliance recommend monitoring for new or unexplained gum bleeding, especially if it occurs with other symptoms of infection. Prompt medical evaluation is critical, as this may indicate the onset of serious sepsis-related complications.

43. Loss of Coordination

43. Loss of Coordination
A woman cautiously grips a hallway railing, her unsteady steps showing clear signs of lost balance and coordination. | Generated by Google Gemini

Loss of coordination is a troubling neurological symptom that can arise during sepsis, indicating that the brain and nervous system are being affected by the infection and the ensuing inflammatory response. As sepsis impairs blood flow and oxygen delivery to the brain, it can disrupt the regions responsible for movement, balance, and spatial awareness. This may result in symptoms such as stumbling, difficulty walking in a straight line, dropping objects, or an inability to perform routine tasks that require fine motor skills.

While dizziness and mild imbalance can occur from dehydration or a sudden drop in blood pressure—typically improving with fluids or rest—the loss of coordination related to sepsis is more persistent and often progressive. Unlike the fleeting lightheadedness after standing up quickly, this symptom is usually accompanied by other signs of systemic illness such as confusion, fever, or slurred speech. For example, a person recovering from a urinary tract infection may suddenly become unsteady on their feet or unable to button a shirt without explanation.

The Sepsis Alliance and CDC urge that sudden or unexplained loss of coordination, especially alongside infection, should prompt immediate medical attention to prevent falls and address potentially life-threatening neurological complications.

44. Persistent Low Oxygen Levels

44. Persistent Low Oxygen Levels
A hand holds a pulse oximeter, displaying low oxygen levels—a warning sign of potential hypoxemia. | Generated by Google Gemini

Persistent low oxygen levels, or hypoxemia, are a serious complication that can develop during sepsis. As sepsis progresses, inflammation and fluid may accumulate in the lungs (a condition known as acute respiratory distress syndrome, or ARDS), impairing the exchange of oxygen into the bloodstream. This can lead to dangerously low oxygen saturation, even in people who have not previously had lung disease.

Chronic lung conditions, such as chronic obstructive pulmonary disease (COPD) or severe asthma, can also cause low oxygen levels, but these are typically managed with medications and supplemental oxygen. In sepsis, the drop in oxygen saturation is often sudden and persistent, frequently unresponsive to standard interventions. Symptoms may include increased shortness of breath, rapid breathing, confusion, or a bluish tint to the lips and fingertips.

The CDC and Sepsis Alliance recommend the use of a pulse oximeter—a small device placed on the finger—to monitor blood oxygen levels at home or in clinical settings. If oxygen saturation consistently falls below 92%, especially in the context of infection, seek emergency care immediately, as this can signal life-threatening complications from sepsis.

45. Loss of Bladder or Bowel Control

Loss of bladder or bowel control is a grave symptom that can develop in severe sepsis, signaling advanced nerve or organ dysfunction. As sepsis progresses, it may compromise the nervous system’s ability to regulate the muscles that control urination and defecation. This disruption can result from direct infection or inflammation of the brain and spinal cord, or from severe organ failure that affects the body’s basic functions.

While loss of bladder or bowel control can occur in other conditions—such as after a stroke, during a seizure, or due to certain neurological diseases—these situations often have clear underlying causes and are not usually paired with signs of systemic infection. In contrast, sudden incontinence during sepsis is typically accompanied by other red flags, such as confusion, loss of consciousness, low blood pressure, or decreased urine output. For example, a patient with a known infection who suddenly becomes incontinent should be evaluated for possible sepsis-related complications.

The Sepsis Alliance emphasizes that unexpected loss of bladder or bowel control in the context of infection is a medical emergency. Immediate medical attention is vital, as this symptom may indicate life-threatening organ or neurological failure requiring urgent intervention.

46. Persistent Low Platelet Count

46. Persistent Low Platelet Count
A laboratory technician examines a blood sample under bright lights to determine the patient’s platelet count during a routine test. | Generated by Google Gemini

Persistent low platelet count, or thrombocytopenia, is a significant laboratory finding in sepsis. During severe infection, the body’s inflammatory response can trigger widespread activation of the clotting cascade, leading to rapid consumption of platelets. This continuous depletion impairs the blood’s ability to clot, increasing the risk of spontaneous bleeding and bruising. In some cases, this process can escalate to disseminated intravascular coagulation (DIC), a life-threatening complication.

Low platelet counts can also result from chemotherapy, where cancer treatments directly suppress bone marrow production. However, in sepsis, the drop is usually more abrupt and is caused by increased destruction and utilization, rather than decreased production. For example, a patient with an infection may develop nosebleeds, petechiae (small red or purple spots), or large bruises with minimal injury, and lab tests may reveal a platelet count well below the normal range.

The CDC and Sepsis Alliance recommend routine laboratory monitoring for anyone with suspected sepsis, as declining platelet levels can be an early warning sign of severe disease progression. Early detection and intervention are essential to prevent life-threatening bleeding complications.

47. Swollen Lymph Nodes

47. Swollen Lymph Nodes
A close-up view of a person’s neck highlighting visibly swollen lymph nodes, a sign of the body’s immune response. | Generated by Google Gemini

Swollen lymph nodes are a physical sign that the immune system is actively responding to infection. Lymph nodes act as filters, trapping bacteria, viruses, and other harmful substances as the body mounts a defense. During sepsis or severe infection, the nodes may become enlarged, tender, and more noticeable, especially in areas like the neck, armpits, or groin. This swelling occurs as immune cells multiply rapidly to fight off invading pathogens.

Swollen lymph nodes are also common with mild viral infections or colds, where they may be slightly enlarged and tender but typically shrink as the illness resolves. In the context of sepsis, however, lymph node swelling is often more pronounced, persistent, and may be accompanied by redness, warmth, or even visible streaks on the skin, indicating a spreading infection. For instance, someone with a skin wound who develops rapidly enlarging, painful lymph nodes in the nearby region should be evaluated for a possible severe infection.

The CDC advises that any new, rapidly growing, or unusually painful lymph node swelling—especially when paired with other signs of infection—should prompt medical assessment. Monitoring the size and tenderness of lymph nodes can help detect sepsis early and guide timely treatment.

48. Persistent Hoarseness or Voice Changes

48. Persistent Hoarseness or Voice Changes
A close-up view of vocal cords highlights the physical changes that can lead to a hoarse, altered voice. | Generated by Google Gemini

Persistent hoarseness or changes in the voice can be a sign of a deeper infection affecting the larynx (voice box) or surrounding tissues. In the context of sepsis, inflammation from a throat or upper respiratory infection can extend to the vocal cords, causing swelling, irritation, and altered vibration. This may result in a raspy, breathy, or weak voice that does not resolve with rest or simple home remedies.

Hoarseness is commonly experienced after overusing the voice—for example, after shouting at a sports event or speaking for long periods. In these cases, the voice usually recovers within a day or two with rest and hydration. In contrast, voice changes due to infection tend to persist and may be accompanied by other symptoms such as sore throat, difficulty swallowing, swelling in the neck, or fever. For instance, a person with a lingering upper respiratory infection who notices ongoing voice changes should be alert to the possibility of a more serious condition.

The NHS and Sepsis Alliance recommend medical evaluation if hoarseness or voice changes persist beyond a week or are associated with infection symptoms. Early assessment is especially important if breathing or swallowing becomes difficult, as this could signal airway compromise or severe infection.

49. Painful or Difficult Swallowing

49. Painful or Difficult Swallowing
A woman gently touches her throat with a pained expression, struggling with difficulty swallowing due to dysphagia. | Generated by Google Gemini

Painful or difficult swallowing, known as odynophagia or dysphagia, can occur when infection and inflammation involve the throat, tonsils, or deeper tissues of the neck. In the context of sepsis, this symptom may indicate a progressing throat infection, abscess formation, or swelling that compromises the airway or food passage. The pain may be sharp and persistent, and swallowing can become increasingly challenging, sometimes leading to drooling or inability to eat and drink.

Swallowing discomfort is common with mild sore throats due to viral infections, usually resolving within a few days with rest and fluids. However, when the pain is severe, lasts longer than a week, or worsens despite home care, it may suggest a more serious infection. For instance, someone with a persistent fever, neck swelling, muffled voice, or visible redness in the throat—especially if swallowing becomes extremely painful or difficult—should be evaluated urgently.

The NHS and CDC emphasize that new or worsening swallowing problems, particularly when paired with other signs of infection, warrant immediate medical attention. Early recognition helps prevent airway obstruction and more severe complications of sepsis.

50. Persistent Infection Despite Treatment

50. Persistent Infection Despite Treatment
Persistent infection symptoms despite treatment may signal sepsis or the spread of underlying infection.

When an infection does not improve or resolves only partially despite appropriate treatment, it may be an early indicator of sepsis or a sign that the infection has spread. Sepsis can develop when the body’s immune system is unable to control the infection, allowing bacteria or other pathogens to invade the bloodstream and cause widespread inflammation. Persistent symptoms—such as fever, swelling, redness, pus, or pain—despite antibiotics or wound care, suggest that the infection is not fully contained.

For example, a person with a diabetic foot ulcer may notice that the wound remains open, red, and draining after a week of antibiotics, or a patient with pneumonia may continue to experience a high fever and shortness of breath despite medication. Such scenarios should prompt concern for underlying sepsis or complications such as abscess formation, resistant bacteria, or impaired immune response.

The CDC and Sepsis Alliance stress the importance of timely follow-up if infection symptoms persist or worsen. Ongoing infection despite treatment requires prompt reassessment by a healthcare professional to adjust therapy, perform further investigations, and prevent the escalation to life-threatening sepsis.

Conclusion

Conclusion
A doctor discusses early detection with a patient, both focused on a bright awareness ribbon symbolizing hope and prevention. | Generated by Google Gemini

Recognizing the early warning signs of sepsis is critical, as this condition can escalate with alarming speed, leading to organ failure or death if not promptly treated. Awareness of symptoms—such as fever, confusion, rapid breathing, and persistent infection—can make the difference between recovery and serious complications. Practical steps include monitoring for new or worsening symptoms, using tools like thermometers and pulse oximeters, and seeking immediate medical care when sepsis is suspected. Ongoing vigilance and regular screening, especially in high-risk individuals, are essential. For more information on sepsis warning signs and prevention, visit the CDC and Sepsis Alliance websites.

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