Bacteremia: Causes and symptoms

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Several types of bacteria live on the surface of the skin or colonize the moist linings of the urinary tract, lower digestive tract, and other internal surfaces. These bacteria are normally harmless as long as they are kept in check by the body's natural barriers and the immune system. People in good health with strong immune systems rarely develop bacteremia. However, when bacteria are introduced directly into the circulatory system, especially in a person who is ill or undergoing aggressive medical treatment, the immune system may not be able to cope with the invasion, and symptoms of bacteremia may develop. For this reason, bacteremia is most common in people who are already affected by or being treated for some other medical problem. In addition, medical treatment may bring a person in contact with new types of bacteria that are more invasive than those already residing in that person's body, further increasing the likelihood of bacterial infection.

Conditions which increase the chances of developing bacteremia include:

• immune suppression, either due to HIV infection or drug therapy
• antibiotic therapy which changes the balance of bacterial types in the body
• prolonged or severe illness
• alcoholism or other drug abuse
• malnutrition
• diseases or drug therapy that cause ulcers in the intestines, e.g. chemotherapy for cancer

Common immediate causes of bacteremia include:

• drainage of an abscess, including an abscessed tooth.
• urinary tract infection, especially in the presence of a bladder catheter.
• decubitus ulcers (pressure sores).
• intravenous procedures using unsterilized needles, including IV drug use.
• prolonged IV needle placement.
• use of ostomy tubes, including gastrostomy (surgically making a new opening into the stomach), jejunostomy (surgically making an opening from the abdominal wall into the jejunum), and colostomy (surgically creating an articifical opening into the colon).

The bacteria most likely to cause bacteremia include members of the Staphylococcus, Streptococcus, Pseudomonas, Haemophilus, and Esherichia coli (E. coli) genera.

Symptoms of bacteremia may include:

• fever over 101°F (38.3°C)
• chills
• malaise
• abdominal pain
• nausea
• vomiting
• diarrhea
• anxiety
• shortness of breath
• confusion

Not all of these symptoms are usually present. In the elderly, confusion may be the only prominent symptom. Bacteremia may lead to septic shock, whose symptoms include decreased consciousness, rapid heart and breathing rates and multiple organ failures.

— Richard Robinson