Sepsis (blood poisoning)
Sepsis (blood poisoning) can be a serious side effect of some cancer treatments. Find out how to recognise the symptoms and what to do.
On this page
What is sepsis?
Why might I get sepsis?
When might sepsis happen?
What is my risk of getting sepsis?
Can I prevent sepsis?
How can I help myself?
Taking care of yourself before and during treatment
Symptoms of an infection that may lead to sepsis
Later symptoms of life-threatening sepsis (call 999)
What will happen when I call my hospital team?
Where can I find more information?
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Sepsis may also be called blood poisoning. It is a serious and potentially life-threatening complication of an infection. Sepsis happens when the body reacts to an infection and attacks its own organs and tissues.
Having cancer and some cancer treatments can make your body unable to fight infections.
White blood cells called neutrophils help us fight infections. Some cancer treatments temporarily reduce the number of neutrophils in the blood. This is most common if you have chemotherapy. It is less common with targeted therapies and immunotherapy.
Having a lower number of neutrophils means a minor infection can become very serious. It could become life-threatening within hours.
An infection or sepsis can happen at any time. Your risk is usually highest when the number of neutrophils in your blood is low.
The timings for when neutrophil numbers drop depends on the drugs. Ask your healthcare team when you are most at risk of this happening.
Many people feel anxious or concerned about the possibility of sepsis. You cannot prevent your neutrophil count from dropping.
The most important thing you can do is call your hospital team’s 24-hour helpline straight away if you have any concerns. This reduces your risk of developing a serious complication from an infection.
You should keep your cancer or haematology team’s 24-hour helpline number with you at all times. Store the number in your mobile phone. You can also ask family and friends to keep a note of the number.
Do not delay – always call your hospital team’s 24-hour helpline sooner rather than later. Sepsis is easy to treat if it is caught early.
Other ways to help protect yourself include:
- Tell your family, friends and work colleagues about your risk of sepsis.
- Plan how you would get to hospital quickly if you needed to.
- Keep a record of the treatment you are having and when you last had it.
- Look out for symptoms of early infection or sepsis.
- Call your cancer team urgently if you have any symptoms of infection.
It can be difficult to know if the symptoms you have are an infection or a treatment side effect.
Do not delay contacting your team. Neither you nor your doctor can tell which infections might lead to sepsis. All infections people get during cancer treatment are treated urgently.
Infections do not get better on their own. Early infections can be treated easily. You need to start antibiotic treatment quickly as an infection can be dangerous.
You can take care of yourself before treatment by doing the following:
- Talk to your doctor or nurse about getting the flu vaccine and coronavirus (covid) vaccine. Adults you live with should also get these vaccines.
- Buy a thermometer, so you can check your temperature at home.
- Have a dental check-up before you start cancer treatment.
- Tell your family, friends and work colleagues about your risk of sepsis.
Do not be afraid to live your life as normal. You do not need to avoid family and friends, unless they are unwell. Infections during chemotherapy are usually caused by bacteria that are naturally present in your own body.
You can protect yourself during treatment by doing the following:
- Avoid people who are unwell, for example people with covid, chicken pox, shingles, diarrhoea or a fever.
- Call your hospital team’s helpline if you have been exposed to people with an infection.
- Follow good hand hygiene.
- Follow any advice you are given about what to eat or avoid eating. Not all patients need to make changes to their diet.
- Cook food properly and store it at the correct temperature.
- Wash your hands regularly.
- Clean any cuts or grazes straight away and cover them with a plaster.
- Clean your teeth at least twice a day.
- Use clean gloves for gardening and any other activities where you might cut yourself.
Contact your cancer or haematology team urgently if you have any of the following symptoms:
- You feel less well than normal.
- Your temperature goes over 37.5°C (99.5°F).
- Your temperature goes below 36°C (96.8°F).
- You have flu-like symptoms. This includes feeling shivery, cold and unable to get warm.
- You have a urine infection. Symptoms include:
- pain or discomfort when you pass urine (pee)
- passing urine more often than usual
- feeling that your bladder is not empty after passing urine
- being unable to wait to empty your bladder (urgency)
- leaking urine (incontinence)
- pain low down in your tummy
- urine that is cloudy or strong smelling, or that contains blood.
- You have a chest infection. Symptoms include feeling short of breath, having a sore chest or coughing up green phlegm.
- You have diarrhoea. This means passing more stools (poo) than is usual for you or having watery or loose stools. If you have a stoma, it will be more active than usual.
- You have a skin infection. Symptoms include redness, heat, swelling or pain, especially around a PICC line, central line, cut or wound.
- You have a tooth infection. Symptoms include:
- throbbing pain in your tooth or gum that may come on suddenly and slowly gets worse
- pain that spreads to your ear, jaw and neck on the same side as the affected tooth or gum
- redness or swelling in your face.
If you have any of these symptoms, call 999.
- S – Slurred speech or confusion.
- E – Extreme shivering or muscle pain.
- P – Passing no urine in a day.
- S – Severe shortness of breath.
- I – It is the worst you have ever felt.
- S – Skin that is mottled or discoloured.
Your hospital team will ask about your symptoms and your temperature. They might ask you to go to hospital urgently. This may be to an acute oncology unit, haematology department or A&E (emergency department). It is important to go to the hospital as soon as possible, so you can be seen and treated if needed. You may have to stay in hospital for treatment.
The hospital team will treat you as an emergency. They are likely to:
- examine you
- take some blood, including a sample to find out the number of neutrophils in your blood
- arrange other additional tests, depending on the signs and symptoms you have
- decide whether you are neutropenic and have an infection or signs of sepsis
- give you an antibiotic by injection or through a drip into your blood stream (intravenously) within 1 hour of your arrival.
The hospital team might give you antibiotic tablets to take at home if your risk of developing complications from your infection is low. They will tell you how important it is to go back to hospital quickly if you have any problems.
Most people with sepsis need to stay in hospital for antibiotic treatment into their bloodstream.
If you need to stay in hospital, your hospital team will talk to you about what antibiotic treatment you need and for how long. They will also talk to you about how long you might need to stay in hospital for.
We have more information about cancer treatments and infection, and how to reduce your risk.
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Below is a sample of the sources used in our chemotherapy information. If you would like more information about the sources we use, please contact us at email@example.com
Brighton, D. Wood, M. The Royal Marsden Hospital Handbook of Cancer Chemotherapy. Elsevier Churchill Livingstone. 2005.
National Institute for Health and Care Excellence (NICE) Neutropenic Sepsis Guideline CG151. 2012.
Perry, MC. The Chemotherapy Source Book (5th ed.) Philadelphia: Lippincott, Williams & Wilkins. 2012.
UKONS Acute Oncology Initial Management Guidelines Version 3, March 2018. Available from www.ukons.org (accessed June 2021).
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