You are just getting over your third viral illness this winter. Your tummy will never forget this one, but on the bright side you lost 5 pounds nibbling on saltine crackers for a week. You drink some coffee and coconut water in a hurry and arrive energized to your shift in the Pediatric ED. You walk past four kindergarteners banging popsicle sticks on the wall like they’re ready for some football.
You enter a patient’s room to encounter a three-day-old girl brought by her parents for a measured fever lasting 6 hours. Her birth history is uneventful. Her family has also noticed increased mucus production from the nose while feeding.
On exam, she is lethargic, toxic appearing, and you see mottling of her arms and legs. She is also very warm, but breath sounds are clear and there are no rashes on her skin.
Vitals-
T 103.2 F
BP-72/50 mm Hg
HR-168 / min
RR-44 breath / min
How do you screen for sepsis in children?
You know this child needs your attention right away.
What organisms should be covered when choosing antibiotics?
Which neonates have increased risk for neonatal sepsis?
What treatment should be initiated?
What workup is needed to help identify a source?
- Goldstein B, Giroir B, Randolph A (2005) International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 6:2–8
- Mick NW: Pediatric fever, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Philadelphia, Elsevier Saunders, 2014, Ch. 167:2096-2105.
- Wang VJ: Fever and serious bacterial illness, in Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, et al (eds): Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, ed 7. New York, McGraw-Hill, 2011, Ch. 113:750-755.
*Disclaimer: This post is for Board Review and is not necessarily based on up-to-date evidence.
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