By Dr. Jamin Brahmbhatt, CNN
(CNN) — The death of NASCAR Cup Series champion Kyle Busch, whose family said he had severe pneumonia that progressed to sepsis, has renewed questions about a condition many people have heard of but few fully understand.
Sepsis is more common and more unpredictable than most people realize.
As a urologist, I frequently care for patients who arrive in the emergency room with infected kidney stones. The symptoms often started days earlier: flank pain, fevers, chills, nausea or a general feeling that something was not right. By the time they get to the emergency room, some look visibly ill: heart rate up, blood pressure low, tired and sometimes confused.
This is no longer just an infection. This is sepsis, the body’s extreme response to infection.
Pneumonia isn’t the only infection that can lead to sepsis. A skin infection that keeps spreading and raises your heart rate. A urinary tract infection that suddenly lowers your blood pressure. An infected kidney stone that raises your temperature – these are not just infections anymore. They could be sepsis.
How common sepsis really is
About 1.7 million adults in the United States develop sepsis each year, and at least 350,000 die during hospitalization or are discharged to hospice, according to the US Centers for Disease Control and Prevention. Sepsis contributes to more than one-third of hospital deaths in this country.
Yet public awareness remains surprisingly low. Many people still do not recognize the symptoms or realize that common infections can trigger it.
When your medical team suspects sepsis, the clock starts. We start IV fluids and broad-spectrum antibiotics within the first hour, and then we look for the source of the original infection.
I have seen patients walk in barely able to talk who are then sitting up and asking for water a few hours later. But not every case follows the same course. Some arrive early , get aggressive treatment and still end up in the ICU.
Sepsis can be unpredictable, and that’s why early recognition matters so much.
What sepsis does to the body
Many people think of infections as staying in one part of the body. Pneumonia affects the lungs. A urinary infection affects the bladder. A skin infection stays in the skin.
Sometimes that is true. But when sepsis develops, the body’s response can become much larger than the original infection.
Sepsis is like a kitchen fire that triggers sprinklers throughout an entire building. The original problem may start in one area, but suddenly the emergency response spreads much farther than intended or needed. The body is trying to contain the threat. But in some situations, the inflammatory response becomes wide enough that blood pressure falls, oxygen levels suffer and organs begin to fail.
That is what makes sepsis dangerous. The infection matters, but the body’s response matters just as much, if not more.
Where sepsis begins
Busch’s death has put the spotlight on pneumonia, but it is only one possible cause of sepsis.
Pneumonia happens when infection and inflammation affect the lungs, making it harder for oxygen to move through the body. Many cases improve with treatment, and recovery is common. But severe pneumonia can progress and, in certain situations, contribute to sepsis.
Sepsis can also develop from urinary infections, kidney stones, issues inside the abdomen, skin wounds and surgical sites.
In urology, infected obstructed kidney stones are one of the more dangerous examples. Bacteria become trapped behind a blockage, and the body cannot clear the infection on its own. Last year, actor Billy Porter said he went septic from a kidney stone in minutes — a public reminder that this disease can progress quickly.
Why sepsis is unpredictable
Infections do not affect everyone the same way. Age, underlying medical problems and immune status matter. But they do not explain everything.
Most sepsis cases happen in people with at least one risk factor – older adults, infants, people with chronic conditions like diabetes or cancer, weak immune systems, or anyone recently hospitalized or recovering from surgery. About one in five sepsis hospitalizations are cancer related, according to the CDC.
That is why it is hard to look at public accounts involving sepsis and automatically assume someone waited too long, ignored symptoms or received the wrong care. Those situations do happen. But sepsis can also develop despite timely evaluation and treatment .
Hindsight is hard. And many of us are wired to underestimate symptoms — physicians included.
A few years ago, I ignored my own severe flank pain from kidney stones and tried to push through it longer than I should have before eventually ending up in the emergency room myself. It did not turn into sepsis, but it could have. I was lucky things turned out fine. But the experience reminded me how easy it is to convince yourself that symptoms will improve tomorrow.
What hospitals do when sepsis is suspected
Once sepsis is suspected, timing becomes everything. This is why hospitals emergency departments have protocols designed to identify and treat it quickly.
Teams move fast to obtain blood tests, look for signs of organ dysfunction, start IV fluids and antibiotics and identify the source of infection through cultures or imaging.
Treating the source matters just as much as treating the infection. In some cases, that means draining an abscess, removing infected tissue or relieving a blocked kidney with a stent so urine and infection can drain.
The goal is to try to control both the infection and the body’s rising immune response before the entire system gets overwhelmed.
Sepsis does not always end at discharge
Even when treatment works, sepsis can leave a mark. One thing that surprises many patients and families is that sepsis can have a long tail.
Many people recover fully. But up to half of survivors experience what is called post-sepsis syndrome: fatigue, trouble sleeping, difficulty concentrating, anxiety and repeat infections that can last for months or years. Survivors are also at higher risk for new heart and kidney problems in the future, according to the CDC.
This is why catching sepsis early matters – not just for surviving it but for what comes after. In medicine, we see it every day: patients who do best long-term are the ones that get treated fast.
What people should pay attention to
My goal is not to scare people when they have a cough or a minor body ache. Most infections do not become life-threatening, but persistent or worsening symptoms deserve attention.
One memory tool worth knowing comes from Sepsis Alliance. It uses the acronym TIME:
T: Temperature – higher or lower than normal.
I: Infection – any sign of one.
M: Mental decline – confusion, sleepiness, hard to wake.
E: Extremely ill – severe pain, shortness of breath or a feeling that something is very wrong.
If you or someone you love has an infection and develops confusion, a racing heart, shortness of breath or just feels suddenly much worse — do not wait. Get to an emergency room now.
Sepsis moves fast. The people who survive it are usually the ones who showed up at the hospital emergency room early.
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