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Sepsis in Infants & Children

​By: Sylvia Owusu-Ansah MD, MPH, FAAP

Anyone can get an infection, and almost any infection can lead to sepsis—the body's extreme response to an infection. Without timely treatment, sepsis (sometimes called septicaemia or septicemia) can rapidly lead to tissue damage, organ failure, and death.

Sepsis can affect anyone at any time, but it does tend to strike the very old and the very young. Children, particularly newborns and young infants, can be more susceptible to developing sepsis. Those with underlying health problems are also at a higher risk.

Each year in the U.S., more than 75,000 infants and children develop severe sepsis. Almost 7,000 of these children die—more deaths than children who die from cancer.

Be Alert to the Signs & Symptoms of Sepsis:

Detecting sepsis early and starting immediate treatment is often the difference between life and death. Parents and caregivers must seek immediate medical care if they suspect their child has an infection that is not improving or is getting worse. Sepsis may have been preceded by an infection such as a urinary tract infection, pneumonia, or a skin or bone infection.

The signs and symptoms of sepsis can include a combination of any of the following:

  • Fever or low temperature (newborns and infants may have low temperature)

  • Fast heart rate

  • Fast breathing

  • Feeling cold/cold hands and feet

  • Clammy and pale skin

  • Confusion, dizziness or disorientation

  • Shortness of breath

  • Extreme pain or discomfort

  • Nausea and vomiting

Important Note: Many of these signs and symptoms alone are common in babies and children when they are sick. Most of the time, they do not have sepsis. However, when more than one of these signs and symptoms happen together, or when a baby or child just seems sicker than usual—you should seek medical help. If your baby or child's skin is cold, pale, or has developed strange colors or markings; if your baby or child has become unresponsive or is struggling to breathe; or if your baby has dry diapers for more than 12 hours—you should take him or her to the emergency room without delay.

How Is Sepsis Treated?

Sepsis, or even suspected cases of sepsis, are treated in the hospital. Often, babies and children will need care in an intensive care unit (ICU). Fighting the infection is an emergency. Doctors and nurses will give IV antibiotics to fight the infection. Many other things may be needed to fight sepsis—IV fluids, special heart and/or blood pressure medications, and medications to keep children calm and comfortable. In some cases, children may need a ventilator to help with breathing.  

You might hear the term "sepsis work-up."

"Sepsis work-up" refers to the combination of tests used to diagnose the specific cause of a child's infection. It is important to figure out what type of virus or bacteria is causing the infection. The sepsis work-up may include testing blood, urine, and spinal fluid; an x-ray or an ultrasound test may also be included.

Neonatal Sepsis:

When a child develops sepsis within a few months of birth (up to 90 days), it is called neonatal sepsis. If the sepsis develops within the first hours or days after birth, it is called early onset sepsis. Sepsis that develops after the baby is 1 week old is called late-onset neonatal sepsis.  Premature infants develop sepsis more often than infants who are born on time.  

Sepsis in Older Children:

As children get older, their exposure to illness can increase as they attend child care, go to school, and participate in activities, such as sports. Children, like adults, can develop bacterial infections such as  urinary tract infections, skin infections, pneumonia, appendicitis, and meningitis. Left untreated, these can all lead to sepsis.

What to Expect in the Hospital:

Most sepsis patients are admitted to the hospital. Babies and children who are extremely sick may be cared for in the hospital ICU.  

Babies and children will need to have IV's placed to give fluid and medications.  They will have needle sticks for blood tests. Depending on their age, a soft tube or a needle might be needed to get urine for testing. To test spinal fluid, the baby or child may also need a spinal tap. This involves placing a hollow needle in the back to take a small sample of spinal fluid—the fluid that surrounds the spinal cord and brain. Testing the spinal fluid is important to determine the baby or child has meningitis. On occasion, surgery may be required for those who have surgical infections leading to sepsis such as a severe skin or bone infection or appendicitis.

Parents and Caregivers Can Help Stop This Medical Emergency in Its Tracks.

  • Talk with your pediatrician about steps you can take to prevent infections.

  • Some steps include taking good care of chronic health conditions and following recommended vaccination schedules.

  • Practice good hygiene, such as handwashing, and keeping cuts clean until healed.

  • Know the signs and symptoms of sepsis.  

  • ACT FAST. Get medical care IMMEDIATELY if you suspect your child has sepsis or an infection that's not getting better or is getting worse.

Additional Information & Resources:

 

About Dr. Dr. Owusu-Ansah:

Sylvia Owusu-Ansah MD, MPH, FAAP is a board-certified pediatrician and pediatric emergency medicine physician who is currently an attending in Pittsburgh at Children's Hospital of Pittsburgh UPMC and Director of Prehospital and EMS. Within the American Academy of Pediatrics, Dr. Owusu-Ansah sits on the Committee on Pediatric Emergency Medicine and has worked with the D.C. office on federal, state, and community advocacy issues including the School Access to Emergency Epinephrine Act. Dr. Owusu-Ansah is married to a firefighter/paramedic and has two beautiful daughters.  

Last Updated
9/11/2017
Source
American Academy of Pediatrics (Copyright © 2017)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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