Sepsis is a severe and life-threatening medical condition that occurs when the body’s response to infection causes widespread inflammation and damage to vital organs. It is one of the leading causes of ICU admissions worldwide, especially among elderly patients. As age increases, immunity weakens, making older adults more vulnerable to infections and complications.
When sepsis progresses and affects more than one organ system, it leads to Multiple Organ Dysfunction Syndrome (MODS). This condition significantly increases the risk of mortality and requires immediate intensive care management.
This blog presents a detailed hospital case study of Mrs. Vidyavathi Tata, an 87-year-old female patient diagnosed with sepsis, multiple organ dysfunction syndrome, and severe anemia. The case highlights the importance of early diagnosis, ICU care, and multidisciplinary treatment in saving lives.
Patient Details
- Patient Name: Mrs. Vidyavathi Tata
- Age: 87 years
- Gender: Female
- Primary Diagnosis: Sepsis with Multiple Organ Dysfunction Syndrome
- Associated Conditions: Severe anemia, acute kidney injury, liver dysfunction
Due to her advanced age and critical condition, the patient was considered high-risk at the time of admission.
History of Presenting Illness
Mrs. Vidyavathi Tata was admitted with complaints of fever and vomiting for the past three days. The fever was persistent and high grade, associated with repeated episodes of vomiting. She also had a history of loose stools, which raised concerns about dehydration, electrolyte imbalance, and possible infection originating from the gastrointestinal tract.
There was no history of diabetes mellitus, which is a common risk factor for infections in elderly patients. However, age alone significantly increased her vulnerability.
Over the course of three days, the patient’s condition gradually deteriorated. She developed weakness, reduced responsiveness, and altered mental status, prompting urgent medical evaluation and hospital admission.
General Examination on Admission
On arrival, the patient appeared acutely ill and unstable. She was semi-conscious, febrile, and disoriented but was still able to move her limbs.
Vital Signs on Admission
- Temperature: 102°F (febrile)
- Pulse Rate: 78 beats per minute
- Blood Pressure: 90/60 mmHg (hypotension)
- SpO₂: 98% on room air
- Capillary Blood Glucose: 55 mg/dL (hypoglycemia)
There were no signs of jaundice, cyanosis, clubbing, or lymphadenopathy, which helped rule out certain chronic conditions.
The combination of fever, low blood pressure, low blood sugar, and altered sensorium strongly suggested sepsis with systemic involvement.
Systemic Examination
Cardiovascular System
Heart sounds were normal, with S1 and S2 present. However, the patient’s low blood pressure indicated poor circulation, commonly seen in sepsis and septic shock.
Respiratory System
Respiratory examination revealed bilateral air entry, and no abnormal lung sounds were detected initially. Although oxygen saturation was normal, continuous monitoring was required due to the high risk of respiratory failure in sepsis.
Abdominal Examination
The abdomen was soft, with bowel sounds present. No tenderness or organ enlargement was noted, ruling out an acute surgical abdomen.
Central Nervous System
The patient was semi-conscious and disoriented, with spontaneous limb movements. Her Glasgow Coma Scale (GCS) score was 8/15, indicating moderate to severe impairment of consciousness.
This neurological involvement was likely due to sepsis-associated encephalopathy, hypoglycemia, or metabolic imbalance.
Initial Clinical Impression
Based on the patient’s symptoms, examination findings, and unstable vital signs, a diagnosis of sepsis with suspected multiple organ dysfunction was made. Given the severity of her condition, she was immediately shifted to the Intensive Care Unit (ICU) for close monitoring and aggressive treatment.
ICU Admission and Investigations
Once admitted to the ICU, the patient’s vital parameters were continuously monitored, and extensive laboratory investigations were carried out.
Key Investigation Findings
- Hemoglobin: 5.8 g/dL (severe anemia)
- Total Leukocyte Count: 48,000 cells/mm³ (severe leukocytosis indicating infection)
- Renal Function Tests: Elevated urea and creatinine, suggestive of acute kidney injury (AKI)
- Liver Function Tests: Elevated liver enzymes, indicating liver involvement
These findings confirmed the diagnosis of Multiple Organ Dysfunction Syndrome, involving the blood, kidneys, liver, and nervous system.
ICU Management and Treatment
Due to the critical nature of her illness, immediate and comprehensive treatment was started.
Blood Transfusion
The patient received one unit of packed red blood cells (PRBC) to correct severe anemia. This helped improve oxygen delivery to vital organs.
Antibiotic Therapy
Broad-spectrum intravenous antibiotics were started without delay. Early antibiotic administration is crucial in sepsis management and plays a major role in improving survival.
Fluid Therapy
Intravenous fluids were administered to treat dehydration, improve blood pressure, and maintain adequate circulation.
Oxygen Support
Although oxygen saturation was maintained initially, oxygen support was provided as a preventive measure due to the risk of respiratory complications.
Continuous Monitoring
Regular monitoring included:
- Vital signs
- Blood glucose levels
- Kidney and liver function tests
- Complete blood counts
This helped assess the patient’s response to treatment and detect complications early.
Clinical Improvement
With continuous ICU care, the patient gradually showed signs of recovery. Her fever reduced, blood pressure stabilized, and laboratory parameters showed improvement.
On 14/12/25, Mrs. Vidyavathi Tata regained consciousness. Her mental status improved significantly, and she became more responsive to commands.
Specialist Consultations
Due to the complexity of her condition, specialist opinions were obtained:
- Pulmonologist: To assess respiratory function and oxygen therapy
- Cardiologist: To monitor cardiac status and prevent complications
All specialist recommendations were followed as part of her treatment plan.
Sudden Cardiac Complication
On 18/12/25, the patient suddenly developed shortness of breath. This acute change required immediate evaluation.
An ECG was performed, which showed atrial fibrillation, a serious heart rhythm disorder commonly seen in elderly and critically ill patients.
Management of Atrial Fibrillation
The patient was immediately started on:
- Anticoagulants to prevent clot formation and stroke
- Amiodarone infusion to control heart rhythm
Continuous cardiac monitoring was maintained to ensure stability.
Discussion
This case clearly shows how sepsis can rapidly progress to multiple organ dysfunction in elderly patients. Advanced age, delayed presentation, severe infection, and anemia all contributed to disease severity.
Sepsis-related inflammation can affect the heart, kidneys, liver, and brain, leading to complications such as atrial fibrillation and acute kidney injury. Early ICU care and timely interventions were crucial in stabilizing the patient.
Importance of Early ICU Management
Early recognition of sepsis, prompt antibiotic therapy, supportive care, and multidisciplinary involvement are key factors in improving outcomes. Continuous monitoring allows early detection of complications and prevents further deterioration.
Conclusion
This case of sepsis with multiple organ dysfunction syndrome in an 87-year-old patient highlights the seriousness of the condition and the importance of timely ICU care. Despite severe illness and complications, early intervention and comprehensive management played a vital role in the patient’s recovery.
Sepsis remains a medical emergency, especially in elderly patients. Awareness, early diagnosis, and aggressive treatment can significantly improve survival and quality of care.
