|SSM Cardinal Glennon Children's Medical Center|
Sepsis is when the immune system responds to an infection by attacking the body's own organs and tissues. The infection can originate in many body parts, including the lungs, intestines, urinary tract, or skin.
Sepsis causes the body's normal reaction to infection to go into overdrive. Bacteria from the infection and the toxins they create can change a person's body temperature, heart rate, and blood pressure, and prevent the body's organs from working properly.
Sepsis may lead to serious complications that affect the kidneys, lungs, brain, and heart, and can even cause death. Sepsis can affect people of any age, but is more common in:
If your infant is less than 3 months old, has a rectal temperature of 100.4°F (38°C), seems lethargic, irritable, uninterested in eating, having difficulty breathing or appears ill, take your baby to see a doctor immediately.
In older babies and children, symptoms may include a fever, irritability, difficulty breathing, and lethargy. A child may also seem irritable, confused, have trouble breathing, have a rash, appear ill, or may complain that his or her heart feels like it's racing. Call your doctor right away if your child has these symptoms.
Signs and Symptoms
Sepsis in newborns can produce a variety of symptoms. Frequently, these babies "just don't look right" to their caretakers.
Symptoms of sepsis in newborns and young babies include:
Older infants and children who have sepsis might have fever, vomiting, rash, change in skin color, trouble breathing, feel like their heart is racing, or feel lethargic, irritable, or confused. A child with sepsis may have started with an infection such as cellulitis or pneumonia that seems to be spreading and/or getting worse, not better.
Causes of Sepsis
Bacteria are almost always the cause of sepsis in newborns and infants. Bacteria such as group B streptococcus (GBS), Escherichia coli, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, and Salmonella are common culprits in sepsis in newborns and infants younger than 3 months old.
Premature babies receiving neonatal intensive care are particularly at risk for sepsis because their immune systems are more underdeveloped than other babies'. And they usually undergo invasive procedures involving long-term intravenous (IV) lines, various catheters or tubes, and breathing through a tube attached to a ventilator. The incisions an infant gets during the placement of catheters or other tubes can provide a path for bacteria, some of which normally live on the skin's surface, to get inside the baby's body and cause an infection.
In some cases of sepsis in newborns, bacteria enter the baby's body from the mother during pregnancy, labor, or delivery. Some pregnancy complications that can increase the risk of sepsis for a newborn include:
Some bacteria (GBS in particular) can be acquired by the newborn during delivery — 15% to 30% of pregnant women carry the bacterium for GBS in the vagina or rectum, where it can be passed from mother to child during delivery.
Diagnosing and Treating Sepsis
Because symptoms of sepsis can be vague in infants, laboratory tests play a crucial role in confirming or ruling out sepsis:
Sepsis, or even suspected cases of sepsis, will be treated in the hospital, where doctors can closely watch the child and administer antibiotics intravenously (through an IV) to fight the infection.
Usually, doctors start infants with sepsis on antibiotics right away — even before the diagnosis is confirmed. If needed, babies might receive IV fluids to keep them hydrated, blood pressure medication to keep their hearts working properly, and respirators to help them breathe.
There's no way to prevent all types of sepsis. But some cases can be avoided by preventing the transmission of GBS bacteria from mother to child during childbirth. Pregnant women can have a simple swab test between the 35th and 37th weeks of pregnancy to determine if they carry the GBS bacteria.
If a woman tests positive for GBS, she can receive intravenous (IV) antibiotics during labor. It is best if these antibiotics are given at least 4 hours before delivery, so women in labor who are GBS positive should go to the hospital early.
Women are at greater risk of carrying GBS if they have a fever during labor; if the amniotic sac ruptures prematurely; or if they had other children with sepsis or other diseases triggered by GBS, such as pneumonia or meningitis. A woman who has not been tested for GBS, but has one of these risk factors, may receive IV antibiotics during labor to lower the risk of transmission to her newborn.
Another way to help prevent some types of sepsis is through vaccination. Immunizations routinely given to infants today include vaccinations against certain strains of pneumococcus and Haemophilus influenzae type b that can cause sepsis or occult bacteremia, an infection of the blood.
Regular hand washing is the best way to prevent infection. Also, make sure people who are sick don't get close to your baby. Children and adults handling young infants should be up-to-date with vaccinations.
For children with medical devices like catheters or long-term IV lines, make sure to follow the doctor's directions for cleaning and accessing the device.
When to Call the Doctor
Symptoms of sepsis can be very difficult to identify in newborns and young infants, so call your doctor immediately or seek emergency medical care if your baby shows any of these symptoms:
If your older infant or child has fever, vomiting, a rash, trouble breathing, change in skin color, feels like his or her heart is racing, or is lethargic, irritable, or confused, call the doctor or get emergency medical care immediately.
These signs don't necessarily mean a child has sepsis, but it's important to let the doctor know about symptoms to make sure an infection is caught before it becomes more severe.
Reviewed by: Adalberto Torres Jr., MD