Sepsis in Children

Clinical Description

• Bacteremia with two or more of the following:
• Temperature >38°C or <36°C
• Tachycardia
• Tachypnoea
• White blood cell count >12000/mm3 or <4000/mm3 or >10% immature bands

Causes:

• Streptococcus pneumonia, staphylococcus aureus, Salmonella species, haemophilus Influenza b

Signs and Symptoms

• Fever, Malaise, Headache, Poor appetite, Myalgia, Tachycardia, tachypnea, Seizures, Shock

Investigations

• FBC, Urine dipstick, microscopy and culture, Blood culture, Serum glucose, Lumbar puncture (if indicated), Inflammatory markers: ESR, CRP, Chest Xray.

Pharmacological

• Benzyl Penicillin 50,000 units/kg IV or IM 6 hourly for 5-7 days plus
• Gentamycin 7.5 mg/kg slow IV or IM 24 hourly for 5 -7 days
• Adjust antibiotics as guided by microbiology results

If still febrile after 72 hours:

• Repeat blood culture
• Look for source of infection
• Change to Ceftriaxone 50mg/kg IV
• once daily antipyretics
• NEVER USE ASPIRIN IN CHILDREN
• Paracetamol 15mg/kg PO 6 hourly

Complications

• Multiorgan dysfunction
• Septic shock

Disseminated intravascular coagulopathy (DIC)

Complications and Referral Criteria

Persistent fevers while on second line antibiotics and signs of multiorgan dysfunction