Sepsis

What is sepsis?

The body's immune system is responsible for fighting infections. Sometimes, the immune response can get out of control, resulting in sepsis. Sepsis can damage the body’s organs, for example the kidneys, liver, lungs or brain, and possibly lead to death. Sepsis can be hard to identify as early on, some of the symptoms are similar to common infections.

Development of sepsis

What are the signs and symptoms of sepsis?

A child with sepsis may display typical signs of an infection, including fever, cough or diarrhea, along with:

• a fast heart rate
• fast breathing
• low blood pressure
• cool or clammy skin
• excessive sleepiness
• confusion (not knowing where they are)
• decrease in urination

If you suspect your child has sepsis, you should seek immediate medical care.

What causes sepsis?

Sepsis is most often caused by bacteria. Some common bacterial causes include Staphylococcus aureus, various types of Streptococcus species and E. coli. Sepsis can also be caused by viral or fungal infections. Sometimes the specific infection and source of sepsis is not found.

Bacteria cause local infections such as pneumonia, urinary tract infections and infections of the gastrointestinal tract or skin. If bacteria from these infections enter the bloodstream, the infection can spread to the rest of the body. This forces the body’s immune system to generate a strong immune response to fight the infection.

The strong immune response, along with the bacteria already in the body, creates inflammation. This inflammation damages tissue and interferes with blood flow. The change in blood flow can lead to a dangerous drop in blood pressure, which stops oxygen from reaching the body’s organs and tissues. This series of events is known as sepsis.

Who can develop sepsis?

Any child with an infection can develop sepsis. However, there is a higher risk for certain populations, including the following:

• newborns and young infants
• children who have recently had surgery
• children with weakened immune systems, for example due to cancer or an organ transplant
• children with chronic (long-term) diseases, such as gastrointestinal conditions or kidney disease

Some medications, such as steroids used over a long time and other forms of chemotherapy, can also put children at higher risk of developing sepsis.

How is sepsis diagnosed?

There is not a specific test to diagnose sepsis. Doctors diagnose sepsis based on some of the signs and symptoms described above. If a doctor suspects sepsis after examining your child, they will order blood tests.

The tests can reveal if your child has an infection or if their organs, such as the liver and kidneys, are not working properly.

The doctor may also test samples of urine and, sometimes, spinal fluid (with a lumbar puncture or spinal tap) to check for bacteria or viruses in these places.

How is sepsis treated?

Your child will be admitted to hospital for treatment even if sepsis is only suspected, as it can take some time for test results to come back. Initial treatment for sepsis includes antibiotics, intravenous (IV) fluids and oxygen.

Sometimes children with sepsis need to be admitted to the intensive care unit (ICU) for closer monitoring and further treatment. If a child has severely low blood pressure, they may need special medications to raise it. If sepsis has caused kidney failure, a child may need dialysis. If sepsis has caused lung damage, a child may need a ventilator to help with breathing.

What can I do to prevent sepsis?

One effective way to prevent sepsis is to minimize the risk of infections.

• Make sure your child receives their routine vaccinations.
• Pay attention to careful hand washing and encourage your child to do the same.
• Clean any cuts or scrapes carefully and see your doctor if signs of infection develop (such as redness, pain or pus).

Take your child to the nearest Emergency Department or call 911 if your child has signs of infection or a fever with any of the following symptoms:

• racing heart rate
• fast breathing
• cool or clammy skin
• excessive sleepiness
• confusion (not knowing where they are)
• decrease in urination
• irritability or severe pain

Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to spot these signs in order to seek help from a health-care provider.