Sepsis in a Child

Sepsis is a severe response the body has to an infection. It is most often caused by bacteria. It is also known as septicemia, or systemic inflammatory response syndrome (SIRS). In newborns, it is also called sepsis neonatorum or neonatal septicemia. Sepsis is a medical emergency. It needs to be treated right away and can only be treated in the hospital.

What is sepsis?

Sepsis is when the body reacts to an infection with a severe inflammatory response. It can be caused by bacteria, fungus, or a virus. This can cause many kinds of problems around the body. It can lead to severe low blood pressure (shock) and organ failure. Sepsis can be rapidly fatal. Even if treated, the mortality rate is high.

What causes sepsis?

A baby can be infected with bacteria, fungus, or a virus before birth. Or he or she may be infected during delivery, or after birth from contact with others. A baby in the newborn intensive care unit (NICU) is more at risk of picking up an infection. Sepsis in a newborn is more likely when the mother has had certain complications such as:

  • Fever

  • Bleeding problems

  • A difficult delivery

  • Infection in the vagina, uterus, or placenta (Groups B strep)

  • Premature rupture of the membranes (amniotic sac), or membrane rupture for a longer period of time

Symptoms of sepsis

Newborn babies often don’t show symptoms in the same way as older babies and children. And each child may have different symptoms. The symptoms in children can include:

  • Stopping breathing or difficulty breathing

  • Fast heart rate

  • Weak sucking

  • Pale or blotchy skin

  • Yellow coloring of the skin and eyes (jaundice)

  • Drop in or no urine output

  • Fever (see Fever and children, below)

Diagnosing sepsis

If the healthcare provider thinks your child may have sepsis, your child will be given tests. These may include:

  • Blood and urine tests. These are done to look for bacteria, viruses, or fungi.

  • Spinal tap (lumbar puncture). This uses a special needle that is placed in the lower back. The healthcare provider takes a small amount of cerebral spinal fluid (CSF). The fluid is tested to look for signs of infection.

  • X-rays or other imaging tests. These may be done to look at your child’s organs to see where the infection is.

Treating sepsis

If your child has sepsis, he or she will be given antibiotics through an intravenous (IV) line. Your child will also be given fluids through the IV. Nutrition or other medicines may also be given through the IV. Your child’s healthcare provider will talk with you about other treatments your child may need. These may include using an oxygen mask or a ventilator to help with breathing. Treatment may last at least 7 to 10 days. A baby with sepsis will stay in the NICU for extra care.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.