Overview
Bacteremia: An invasion of bacteria into the bloodstream.
- Bacteremia may result from ordinary activities (such as toothbrushing), dental or medical procedures, or from infections (such as pneumonia or a urinary tract infection).
- Having an artificial joint or heart valve, or heart valve abnormalities increases the risk that bacteremia will persist or cause problems.
- Bacteremia usually causes no symptoms, but sometimes bacteria accumulate in certain tissue or organs and cause serious infections.
- People at high risk of complications from bacteremia are given antibiotics before certain dental and medical procedures.
Usually, bacteremia, particularly if it occurs during ordinary activities, does not cause infections because bacteria typically are present only in small numbers and are rapidly removed from the bloodstream by the immune system. However, if bacteria are present long enough and in large enough numbers, particularly in people who have a weakened immune system, bacteremia can lead to other infections and sometimes trigger a serious bodywide response called sepsis.
Symptoms and Signs
The symptoms and signs of cutaneous and subcutaneous abscesses are pain, heat, swelling, tenderness, and redness. If superficial abscesses are ready to spontaneously rupture, the skin over the center of the abscess may thin, sometimes appearing white or yellow because of the underlying pus (termed pointing). Fever may occur, especially with surrounding cellulitis. For deep abscesses, local pain and tenderness and systemic symptoms, especially fever, as well as anorexia, weight loss, and fatigue are typical. The predominant manifestation of some abscesses is abnormal organ function (eg, hemiplegia due to a brain abscess).
Complications of abscesses include bacteremic spread, rupture into adjacent tissue, bleeding from vessels eroded by inflammation, impaired function of a vital organ, and inanition due to anorexia and increased metabolic needs.
Causes
Ordinary activities sometimes cause bacteremia in healthy people. For example, vigorous toothbrushing can cause bacteremia because bacteria living on the gums around the teeth are forced into the bloodstream. Bacteria may also enter the bloodstream from the intestine during digestion. Bacteremia that occurs during ordinary activities rarely leads to infections.
Dental or medical procedures can lead to bacteremia. During dental procedures (as during tooth cleaning by a dental hygienist), bacteria living on the gums may become dislodged and enter the bloodstream. Bacteremia may also occur when catheters are inserted into the bladder or tubes are inserted into the digestive or urinary tract. Bacteria may be present at the site of insertion (such as the bladder or intestine). So even though sterile techniques are used, these procedures may move bacteria into the bloodstream. Surgical treatment of infected wounds, abscesses, and pressure sores can dislodge bacteria from the infected site, causing bacteremia.
Symptoms and Diagnosis
Usually, bacteremia that results from ordinary events such as dental procedures causes no symptoms. People with bacteremia from other causes sometimes have fever. If people with bacteremia have a fever, a rapid heart rate, and rapid breathing, sepsis is likely.
If bacteremia is suspected, doctors usually do blood tests to try to grow the bacteria in the laboratory (blood cultures).
Prevention and Treatment
People who are at high risk for complications of bacteremia (such as those who have an artificial heart valve or joint or certain heart valve abnormalities) are often given antibiotics before procedures that can cause bacteremia:
- Dental procedures
- Surgical treatment of infected wounds
- Insertion of bladder catheters
Antibiotics help prevent bacteremia and thus infections and sepsis from developing.
If an infection or sepsis develops, it is treated.
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