Clinical Presentation

Clinical Presentation:

• Fever
• Tachycardia
• Tachypnea
• Hypotension or altered mental status in severe cases
• Signs of infection (e.g. cough, vomiting, diarrhea, rash)
• Organ dysfunction (e.g. acute kidney injury, acute respiratory distress syndrome)
• Neonates: temperature instability, lethargy, poor feeding, apnea

Risk factors:

• Very young age – highest risk in infants <1 year, especially neonates
• Immunocompromised state (malignancy, transplant, immunosuppressants)
• Indwelling devices (central lines, urinary catheters)
• Recent surgery or trauma
• Underlying comorbidities (e.g. congenital heart disease, chronic lung disease)

Pediatric sepsis can present with vague, nonspecific symptoms leading to missed or delayed diagnosis. Tachycardia may be absent in approximately 10% of pediatric septic shock cases. Hypotension is a late sign in pediatric sepsis that indicates decompensation.

Early recognition is critical but challenging due to variable presentations. Maintaining a high index of suspicion in high-risk children with acute illness is key. Signs of uncompensated shock indicate severe sepsis requiring urgent management.