7 Signs of Sepsis in Children You Can’t Afford to Miss
Key takeaways:
Sepsis is a serious condition that results from the body’s response to a growing infection.
Around the world, sepsis results in more deaths each year than any other cause.
Signs of sepsis in babies and young children include weakness, poor feeding, lethargy, and high or low temperature.
Treatment for sepsis usually requires emergency medical attention in an intensive care unit. Knowing the early signs and symptoms can make sure your child gets the immediate attention they need.
Many people are surprised to learn that sepsis is the most common cause of death for children around the world. That’s because sepsis isn’t something we talk about very often, and it can be difficult to understand.
Sepsis is the end result of a severe infection. With the help of antibiotics, the immune system can often fight off a mild infection, or even a moderate one. But if an infection spirals out of control, the immune system’s strong response can do more harm than good. Like a row of dominos, the heart, lungs, kidneys, and other organs suffer damage — and quickly stop working.
Treatment for sepsis must be immediate in order to be effective. Keep reading to learn more about what causes sepsis in children, how to recognize it, and what to do to keep it from becoming a problem.
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What causes sepsis in children?
Sepsis happens when an infection — and the immune system’s response to that infection — starts to overwhelm the body.
When a child gets an infection from bacteria or other germs, the immune system releases signals that trigger inflammation. The inflammation has many effects: It calls germ-fighting cells to action, raises the body temperature, and shifts blood flow to help fight the infection.
Most of the time, these adjustments work together to help the body fight off the invading germs. But when the fight is too big to win, the effects can be life-threatening.
Who is at risk for sepsis?
Although sepsis can happen in anyone, certain people are at higher risk. About half of all children who get sepsis have strong risk factors, such as:
Being a newborn baby, especially with low birth weight or prematurity
Cancer, especially leukemia, or chemotherapy
A chronic medical condition, like diabetes or a neuromuscular disorder
A problem with the immune system
Children who aren’t vaccinated against haemophilus influenzae B (HiB), pneumococcus, measles, and other infectious diseases also face a higher risk of sepsis. That’s because these children are more vulnerable to infections in the first place.
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Does my child have sepsis? Know these 7 signs
Sepsis isn’t a common problem for healthy children, but it can happen. You’ll want to be on the lookout for sepsis whenever your child has an infection, even if they’ve already started treatment for it. Here are seven cases that can alert you that your child may have sepsis:
1. Your child is getting worse instead of better
Sepsis happens when an infection grows out of control. Once your child starts treatment for an infection, they should begin to feel better pretty quickly — at least within a day or so. If they don’t seem better, that could mean the treatment isn’t working.
Many types of infections can progress to sepsis, but you’ll want to be particularly alert if your child is battling a bacterial infection that’s difficult to treat like:
Meningitis (an infection around the brain)
Pyelonephritis (kidney infection)
Cellulitis (skin infection)
2. Your child doesn’t want to wake up, or they’re limp
Babies with sepsis are very sleepy. In fact, it can be difficult to get them to wake up to eat or drink. Young children might also seem confused or disoriented.
3. They have fast, shallow breathing
Children with sepsis might look like they’re panting. This fast breathing doesn’t have anything to do with the lungs —- it’s an automatic response to the chemical changes that happen when the body is fighting a large infection.
4. They feel flushed and feverish
A fever is a common sign of infection, so it’s no surprise a child might have a fever when they are developing sepsis. Along with a high fever, they might look flushed and experience chills or shaking.
5. They feel cold and clammy
Although infection usually causes the body temperature to go up, sepsis will eventually cause the body to shut down. As this happens, the body temperature can drop lower than normal. A temperature that’s lower than normal is a bad sign for children with sepsis.
6. Their skin looks mottled
During sepsis, blood flow through the body becomes weak. The result is purple, pale, or mottled-looking skin. Changes in skin color often start on the hands, feet, arms, and legs.
7. They aren’t making wet diapers
As sepsis gets worse, basic functions — like making urine — start to slow down. Even if your child wasn’t dehydrated to start out with, you’ll notice dry diapers instead of wet ones.
How do you diagnose sepsis?
The diagnosis of sepsis isn’t always easy. Experts use a combination of signs, symptoms, laboratory values, and information from imaging studies to determine when a child has sepsis.
How serious is sepsis in children?
Sepsis can be very serious in children. Even with good medical care, the worst cases of sepsis can cause permanent organ damage and death.
Not every child will have long-term effects from sepsis. With early and proper treatment, many children can fully recover.
How is sepsis different in children vs. adults?
Children, especially young babies, are more vulnerable than adults when it comes to sepsis. This is partly because the symptoms of sepsis can be hard to recognize in children, in particular when they are too young to communicate clearly. In addition, babies and children are more at risk for severe infections than adults.
How do you treat sepsis in children?
Treatment for sepsis must be immediate. Most children with sepsis get treatment in an intensive care unit (ICU) or pediatric intensive care unit (PICU), where healthcare providers can give them the strongest treatments possible.
Treatment for sepsis is complex, so a specialist needs to closely monitor the situation. Steps in treating sepsis often include:
Intravenous (IV) fluids, medications, or machinery to help with breathing and blood pressure
Antibiotics, or similar medications, to stop the infection
Steroids, or other measures, to calm the immune response
Ongoing assessment of the body organs — such as the kidneys, brain, and liver — to make sure they aren’t showing signs of damage
How long does sepsis last?
The timeline of sepsis depends on the situation. If the child gets treatment quickly, sepsis might only last for a few hours. But because it can impact many different body organs, treatment for sepsis can take weeks or longer.
Can my child recover after having sepsis?
Many children do recover after having sepsis. These days, when there are top-notch vaccines, antibiotics, and supportive care, over 90% of children treated for sepsis survive and get better.
When a child’s condition has progressed to severe sepsis — that means sepsis has affected the heart, lungs, or other body organs — the survival rate falls to about 75%. Nearly 2 in 10 of these survivors will continue to have long-term medical problems.
It’s important to point out that children with sepsis who do not receive medical treatment are unlikely to recover.
The bottom line
Sepsis is a serious, potentially life-threatening situation that can occur after an infection. And sepsis can happen fast in children. Quick medical treatment with strong antibiotics will prevent it and can be lifesaving for children with this condition.
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References
Atreya, M. R., et al. (2019). Precision medicine in pediatric sepsis. Current Opinion in Pediatrics.
Dellinger, R. P., et al. (2013). Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Critical Care Medicine.
Mathias, B., et al. (2016). Pediatric sepsis. Current Opinion in Pediatrics.
Patel, K., et al. (2019). Diagnostic challenges and laboratory considerations for pediatric sepsis. The Journal of Applied Laboratory Medicine.
Weiss, S. L., et al. (2015). Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. American Journal of Respiratory and Critical Care Medicine.
