Sepsis in Children

Sepsis in Children

Sepsis is a serious bodily reaction to an infection. The infection that causes sepsis may be from bacteria or from a virus, fungus, or parasite.

Sepsis can result from an infection in any part of the body. Infections that commonly lead to sepsis include blood, skin, lung, and urinary tract infections.

Sepsis is a medical emergency that requires immediate treatment in the hospital. In severe cases, it can lead to septic shock. Shock can weaken the heart and cause blood pressure to drop. This can make the central nervous system and the body’s organs stop working.

What are the causes?

This condition is caused by a severe reaction to a bacterial, viral, fungal, or parasitic infection. The germs that most often lead to sepsis include:

  • Escherichia coli (E. coli).
  • Staphylococcus aureus (staph).
  • Some types of streptococcus bacteria.

The most common infections that lead to sepsis include infections of:

  • The lung (pneumonia).
  • The kidneys (urinary tract infection).
  • The skin (cellulitis).
  • The gut.

What increases the risk?

This condition is more likely to develop in children who:

  • Have a very low birth weight.
  • Have a weak disease-fighting system (immune system).
  • Are born more than 18 hours after their mother’s water broke (amniotic sac ruptured).
  • Are younger than 1 year old.
  • Are born to a mother who has sepsis or is infected with:
    • Group B streptococcus.
    • E. coli.
  • Have had surgery.
  • Are hospitalized, especially in the intensive care unit (ICU).
  • Have a small, thin tube (catheter), IV, breathing tube, or drainage tube inserted into their body.
  • Have other long-term (chronic) diseases, such as diabetes.

What are the signs or symptoms?

Symptoms of this condition include:

  • Fever.
  • Chills or feeling very cold.
  • Fast heart rate (tachycardia).
  • Rapid breathing (hyperventilation).
  • Shortness of breath.
  • Confusion or light-headedness.
  • Changes in skin color. Your child’s skin may look blotchy, pale, blue, or yellow.
  • Cool, clammy skin or sweaty skin.
  • Skin rash.
  • Nausea and vomiting.
  • Urinating much less than usual.
  • Floppy appearance (poor muscle tone) or lack of energy.
  • Poor feeding or eating.

How is this diagnosed?

This condition is diagnosed based on:

  • Your child’s symptoms.
  • Your child’s medical history.
  • A physical exam.

Your child may also have tests to find out the cause of the infection and how severe the sepsis is. These tests may include:

  • Blood tests.
  • Urine tests.
  • Swabs from other areas of the body that may have an infection. These samples may be tested (cultured) to find out what type of bacteria is causing the infection.
  • Chest X-ray to check for pneumonia. Other imaging tests, such as a CT scan, may also be done.
  • Lumbar puncture. This is a procedure to remove a small amount of the fluid that surrounds the brain and spinal cord. The fluid is then examined for infection.

How is this treated?

This condition is treated in a hospital with antibiotic medicines. Your child may also receive:

  • Fluids through an IV.
  • Oxygen and breathing assistance.
  • Kidney dialysis. This process cleans the blood if the kidneys have failed.
  • Surgery to remove infected tissue.
  • Medicines to increase blood pressure.
  • Blood transfusion if needed.
  • Medicine to prevent blood clots.
  • Nutrients to correct imbalances in basic body function (metabolism). This may involve giving your child important salts and minerals (electrolytes) through an IV and adjusting your child’s blood sugar level.

Follow these instructions at home:

Medicines

  • Give your child over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Give your child antibiotic or anti-fungal medicines as told by your child’s health care provider. Do not stop giving the antibiotic or anti-fungal medicines even if your child starts to feel better.

General instructions

  • Make sure your child drinks enough fluid to keep his or her urine pale yellow.
  • Give your child a healthy, balanced diet. This includes plenty of fruits and vegetables, whole grains, and low-fat (lean) proteins. Ask the health care provider if your child should avoid certain foods.
  • Have your child rest and gradually return to normal activities. Ask the health care provider what activities are safe for your child.
  • Keep your child’s vaccinations up to date.
  • Wash your hands and your child’s hands often.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child does not appear to be getting better or regaining strength.
  • Your child is tired all the time.
  • Your child does not seem to get better after surgery.
  • You think your child has an infection after surgery.

Get help right away if:

  • Your child has any symptoms of sepsis.
  • Your child is 3 months to 3 years old and has a temperature of 102.2°F (39°C) or higher.
  • Your child is younger than 3 months and has a temperature of 100°F (38°C) or higher.
  • Your child has difficulty breathing.
  • Your child has a rapid or skipping heartbeat.
  • Your child becomes very confused, limp, or unresponsive.
  • Your child’s skin becomes blotchy, pale, or blue.

Get medical help for your child right away. Call your local emergency services (911 in the U.S.).

Summary

  • Sepsis is a medical emergency that requires immediate treatment in the hospital.
  • This condition is caused by a severe reaction to a bacterial, viral, fungal, or parasitic infection.
  • Sepsis is more likely to develop in babies who have a very low birth weight or babies whose mothers are infected with group B streptococcus or Escherichia coli (E. coli).
  • This condition is treated in a hospital with antibiotics. Treatment may also include IV fluids, breathing assistance, and kidney dialysis.
  • Give your child antibiotic or anti-fungal medicines as told by your child’s health care provider. Do not stop giving the antibiotic or anti-fungal medicines even if your child starts to feel better.
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