Sepsis: Symptoms, Risk Factors, and Treatment

Sepsis is a very dangerous medical condition that results from infection, usually by a bacteria, but a virus or fungus can also be a cause. Sepsis occurs when the infectious agent spreads from its initial area of infection into the bloodstream. Infections such as pneumonia, urinary tract infections, cellulitis or abscesses, meningitis, or abdominal infections such as appendicitis can spread to the bloodstream and lead to sepsis.

The condition is sometimes called “blood poisoning.” In response to the spread of the infection, the immune system triggers an inflammatory response throughout the body that affects the body’s organs. This kind of reaction is known as “systemic,” as opposed to the kind of local inflammation that occurs at the site of a cut or scrape. Overall, sepsis is one of the leading causes of death nationwide.

Sepsis occurs in stages and degrees. In its early stages, the symptoms of sepsis are non-specific, which can make it harder to diagnose in a sick child. These symptoms usually include a fever and elevated heart and respiratory rate. As the condition progresses and the infectious agent enters the bloodstream, there can be a rash, cool extremities, altered mental status, lethargy, generalized swelling or higher fever. If sepsis is suspected, the pediatrician will order lab tests, which may show an abnormally high or low white blood count and lowered platelet production. One or more organ systems may be involved. Eventually, the patient’s blood pressure can drop dramatically. This advanced stage of sepsis is sometimes called “septic shock” and is a true medical emergency.

The risk of sepsis in a healthy child with a routine infection is very low. Normal cuts and scrapes, even if they become infected locally, are very unlikely to progress to the kind of systemic infection that characterizes sepsis. A healthy immune system is capable of fighting off local infections in one area of the body with oral or topical antibiotics to basic wound care. Instead, the most at-risk children are those who are hospitalized, who have an underlying condition that suppresses the immune system such as cancer or liver disease, or who have been infected with MRSA or other resistant, dangerous bacteria.

Treatment for sepsis will likely be aggressive because sepsis is an extremely dangerous and potentially life-threatening infection. Antibiotics and IV fluids are the first line treatment. If you think your sick child is dramatically worsening and you are concerned it is sepsis, it’s very important you seek medical attention immediately. Even a few hours can make a difference.

Sources:

• Lever and I
• Mackenzie, Sepsis: Definition, epidemiology, and diagnosis
• BMJ
• 2007 October 27; 335(7625): 879–883
• doi:  10.1136/bmj.39346.495880.AE
  Sepsis Alliance
• Understanding Risk.

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