Pediatric sepsis: important considerations for diagnosing and managing severe infections in infants, children, and adolescents

Abstract

Sepsis is the leading cause of death in children worldwide. Although the diagnosis and management of sepsis in infants and children is largely influenced by studies done in adults, there are important considerations relevant for pediatrics. This article highlights pediatric-specific issues related to the definition of sepsis and its epidemiology and management. We review how the capacity of the immune system to respond to infection develops over early life. We also bring attention to primary immune deficiencies that should be considered in children recurrently infected with specific types of organisms. The management of pediatric sepsis must be tailored to the child's age and immune capacity, and to the site, severity, and source of the infection. It is important for clinicians to be aware of infection-related syndromes that primarily affect children. Although children in developed countries are more likely to survive severe infections than adults, many survivors have chronic health impairments.

Keywords: children; infants; infection; innate immunity; pediatric; review; sepsis; septic shock.

Figure 1. Depiction of primary, secondary, and tertiary pediatric sepsis prevention efforts (modified, with permission from Dr Bala Totapally).