DEAR DR. DONOHUE: My mother passed away a few years ago. On her death certificate, it stated that the cause of death was sepsis. Can you give me some information on it and what causes it? – P.R.

Sepsis, also known as septicemia, is popularly called blood poisoning. Bacteria or the toxins (poisons) they make get into the blood and pose a grave threat of death. Around 700,000 Americans develop sepsis yearly, and of that number, at least 30 percent die in spite of heroic efforts to fight it.

Signs of sepsis are a high temperature, a rapid heartbeat, panting for air and a rise in the white blood count. The patient is often quite confused. If the offending bacterium can be recovered from the blood, an antibiotic effective against that germ is given in large doses. Sometimes, when a bacterium cannot be identified, antibiotic combinations have to be given based on the most likely germs involved.

Even with treatment, some patients go on to develop septic shock – a drop in blood pressure accompanied by organ failure. The kidneys stop making urine. Liver cells die. The heart pumps weakly. The mortality rate from septic shock is very high, even when treatment is given to restore blood pressure and minimize organ damage.

You probably wonder how the bacterium got into the blood. That question cannot always be answered. At times, it can be a bacterium that’s part of the colon’s bacterial population, and it enters the blood through some minor breach in the colon wall. Or a person might have a hidden abscess from which bacteria spread into the blood. Or an illness that saps the immune system of its strength might allow bacteria to proliferate in the blood.

DEAR DR. DONOHUE: I am still hoping to see in your column why a woman should not use talcum powder on her privates. You stated that it could cause cancer. – M.B.

DEAR DR. DONOHUE: If a woman can’t use talc, what can she use? – W.B.

Talc dusted on the genitals can migrate upward to the ovary and possibly give rise to cancer. The risk is small, and the possibility is slim, but why take any chances?

If a woman feels it necessary to use a dusting powder, use one with cornstarch.

DEAR DR. DONOHUE: I am a 47-year-old woman in good health. I am 5 feet 7 inches and weigh 145 pounds. I have a pretty active lifestyle. I play tennis twice a week and do Pilates two to three times a week.

However, I have a lot of cellulite on my legs and buttocks. It seems that diet and exercise do not help. I understand that cellulite is due to toxins in fat cells. Is this true? Could it be a circulation or constipation problem? – M.M.

ANSWER: The only difference between cellulite and ordinary fat is that cellulite has a dimpled appearance. It’s not due to toxins, bad circulation or constipation.

One explanation is that fibrous bands that hold skin to deeper tissues crisscross fat and produce the lumpy appearance of cellulite. This is a genetic thing.

Another explanation has it that tiny blood vessels in fat become damaged. Those vessels leak fluid that puckers the fat into cellulite.

Most cellulite appears on the thighs, hips or buttocks. Exercising leg muscles promotes muscle growth, which can smooth out cellulite. Weight loss is a necessary ingredient too.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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