February 14, 2004

In November, 3-year-old Lindsey Martin of Modesto came down with a high fever and what the toddler described as a pain in her leg. Doses of Motrin did little to control her 105-degree temperature; soon the pain rendered her unable to walk.

Her doctor ordered blood cultures that soon revealed the child had a common bacterial infection in her bloodstream.

The girl was sent to the infectious disease clinic at the Kaiser hospital in Santa Clara, where a doctor stuck a needle in her hip joint and pulled out fluid that was full of pus, said Lisa Martin, Lindsey's mother.

For 10 days, doctors tried four different antibiotics to see which one worked best in combating what doctors called a "septic hip."

They finally sent the girl home with an IV for administering the most effective antibiotic.

Lindsey is better now, but she was not allowed to leave home for three months, and house guests wore masks to keep her from catching a flu virus that might overwhelm her weakened immune system.

It was all due to a common blood infection, septicemia, that yearly causes more than a half-million deaths worldwide and is now receiving greater attention in the medical community.

"If the bacteria is not caught in a short amount of time, it can go to the heart and kill you," Martin said.

An international group of doctors is pushing for aggressive treatment for the infection, which kills more than 200,000 people annually in the United States alone -- more deaths than from lung and breast cancer combined. Muppets creator Jim Henson died from it 14 years ago.

Later this month, a coalition of leading critical care specialists is set to urge doctors, governments and health agencies worldwide to adopt the first sepsis treatment guidelines.

Their plan calls for fast use of powerful antibiotics and other aggressive action.

The number of sepsis cases has increased dramatically since the 1980s, underscoring the need for rapid recognition and treatment, said Dr. Margaret Parker, a guidelines author.

"The goal of this whole project is to decrease the mortality of sepsis worldwide," said Parker, incoming president of the suburban Chicago-based Society of Critical Care Medicine.

According to state Department of Health Services data, septicemia caused 31 deaths in Stanislaus County from 1999 through 2001. One was an infant and the others were adults.

David Jones, a spokesman for the county's Health Services Agency, said the agency does not know the number of sepsis cases locally because health providers are not required to report them.

Part of the problem is antibiotic overuse that has created drug-resistant germs. But also, until now there's been no consensus about how to diagnose and treat sepsis, said Dr. Mitchell Levy of Brown University, another co-author.

The guidelines are the result of recent research showing benefits from potentially lifesaving strategies, including Xigris, approved in 2001 as the first drug to directly attack sepsis; and changes in ventilator use that improve survival chances.

Sepsis typically starts as a bacterial infection that can originate from pneumonia, skin infections called cellulitis, and urinary infections. The infections may come from bacteria inside the body that grow out of control or from outside germs that invade the body through wounds or IV lines.

These infections spread rapidly, setting off chemical reactions that damage tissue and can lead to organ failure and death.

The new guidelines outline key symptoms of severe sepsis, including high fever, elevated heart rate and low blood pressure, said Dr. R. Phillip Dellinger, director of critical care at Cooper University Hospital in Camden, N.J.

Aggressive treatment should begin in the emergency room and include immediate use of broad-spectrum antibiotics.

Lisa Martin said she never learned how her daughter got the infection, but is relieved it was caught in time.

"It is something your doctor needs to be proactive about," she said. "They need to take every measure because it only gets worse."

The Associated Press contributed to this report.

Bee staff writer Ken Carlson can be reached at 578-2321 or kcarlson@modbee.com.