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Sepsis

more about Sepsis


Septicemia; "Blood poisoning"



  • The most common occurrences of pediatric sepsis are (1) in the neonatal period (first 30 days of life); (2) in post-splenectomy patients; and (3) in meningitis.
  • Ordinarily, common usage refers to bacterial infection of the bloodstream, causing symptoms, and would exclude viral infection.  A well-known fungal infection of the bloodstream, caused by yeast (candida) is known as candida sepsis, so the term, "sepsis," is not strictly limited to bacterial causes.
  • Sepsis is a serious condition.

  • Infection may be acquired in-utero, or during labor.  Alternatively, infection may be acquired post-natally.
  • Post-natal symptoms in neonates:
    1. Poor suck, poor feeding, weakness, irritability
    2. Poor weight gain in the nursery, numerous other symptoms
    3. Temperature instability, including sub-normal temperature
    4. Pallor, gray color, jaundice, abnormal vital signs, respiratory distress, enlargement of liver and/or spleen, Diarrhea
    5. Alternatively, a septic neonate might have no symptoms or signs.

  • First 30 days of life:
    1. Group B Streptococcus
    2. E. coli
    3. L. monocytogenes
  • Older children:
    1. S. Pneumonia
    2. Group A Streptococcus
    3. Staphylococcus

  • Because infection can occur in-utero or during labor, it is important to note the presence of the ante-natal risk factors above.
  • Diagnosis is determined by the collection of symptoms and signs, and supported by laboratory data such as the WBC (white blood cell) count and differential, and any positive blood cultures.

  • Ante-natal (prenatal, prior to birth) risk factors:
    1. Premature rupture of membranes
    2. Group B Streptococcal infection in the mother
    3. Maternal fever
    4. Cloudy, foul-smelling amniotic fluid
  • Post-natal (after birth) risk factors:
    1. Presence of catheters, tubes, drains
    2. Antecedent deep infections (Pneumonia, meningitis, Urinary Tract Infection)

  • Ordinarily, antibiotics or antifungals intravenously
  • Supportive measures

  • Widespread bacterial infection of organs and shock
  • DIC (disseminated intravascular coagulation)

  • Consult a physician urgently. In the case of a newborn, sepsis can be life threatening

  • Viremia (i.e., presence of viruses in the blood, causing symptoms of malaise, fever, aches, etc.)
  • Shock from any cause
  • Infants with temperature instability




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