Sepsis in children - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Sepsis in children may present initially with nonspecific, nonlocalized symptoms (especially in younger age groups) therefore it is important to have a low threshold for suspecting sepsis.
Given the time-critical nature of sepsis and septic shock, when sepsis is suspected on clinical grounds it is usually best to initiate sepsis investigations and treatment together, including administering antibiotics and fluid resuscitation. These should continue until sepsis has been excluded.
Progression to organ failure and shock is often very rapid, so early recognition and treatment is crucial.
Empiric broad-spectrum antibiotic therapy (based on the most probable pathogens) should be administered as soon as possible, and always within the first hour following recognition of sepsis.
Other treatments are primarily supportive, and should be delivered according to internationally recognized consensus-based guidelines.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Photomicrograph of Gram-stained Streptococcus species bacteria

Citations

Key Articles

Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8.[Abstract]
Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024 Feb 27;331(8):665-74.[Abstract]
Weiss SL, Peters MJ, Alhazzani W, et al. Surviving Sepsis Campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Pediatr Crit Care Med. 2020 Feb;21(2):e52-e106.[Abstract][Full Text]
Davis AL, Carcillo JA, Aneja RK, et al. American College of Critical Care Medicine clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Crit Care Med. 2017 Jun;45(6):1061-93.[Abstract][Full Text]
National Institute for Health and Care Excellence. Fever in under 5s: assessment and initial management. Nov 2021 [internet publication].[Full Text]

Other Online Resources

CDC: Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2024.
NICE: traffic light system for identifying risk of serious illness
NICE: table 1 - risk stratification tool for adults, children and young people aged 12 years and over with suspected sepsis
NICE: table 2 - risk stratification tool for children aged 5-11 years with suspected sepsis
NICE: table 3 - risk stratification tool for children aged under 5 years with suspected sepsis

Referenced Articles

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