eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease

Sepsis: Follow-up

Author: Shankar Santhanam, MD, Consulting Staff, Department of Emergency Medicine, Emergency Medical Associates; Consulting Staff, Department of Family Medicine, Capital Health Systems
Coauthor(s): Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Contributor Information and Disclosures

Updated: Nov 13, 2009

Follow-up

Further Inpatient Care

  • Patients whose circulatory, metabolic, and respiratory derangements are not rapidly corrected should be cared for in an intensive care setting.

Transfer

  • Transfer should be arranged if the appropriate specialists and intensive care settings are not locally available.

Deterrence/Prevention

  • Vaccination is the key to preventing many of these infections.
  • Travelers should be warned of the possibility of serious infections during travel.

Complications

  • Because the manifestations of systemic inflammatory response syndrome (SIRS) are protean, possible complications are as well. Complications depend on the nature of the triggering insult and the resultant host response.

Prognosis

  • Mortality from pediatric SIRS ranges from 9-35%.
  • Different insults are associated with different outcomes.
  • Host immune status is important in determining outcome.
  • Aggressive fluid resuscitation early in the course of SIRS results in decreased mortality rates.

Patient Education

  • Parents of newborns should understand that any fever in the first few months of life necessitates immediate evaluation.
  • The importance of fever as a marker of possible serious infection, rather than a concerning symptom itself, should be emphasized.
  • Front-line providers must recognize the importance of aggressive resuscitation for the patient with early signs of SIRS.
  • For excellent patient education resources, visit eMedicine's Infections Center. Also, see eMedicine's patient education article Sepsis.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider meningitis in the appropriate setting
  • Failure to recognize early systemic inflammatory response syndrome (SIRS) and to treat it appropriately
 


More on Sepsis

Overview: Sepsis
Differential Diagnoses & Workup: Sepsis
Treatment & Medication: Sepsis
Follow-up: Sepsis
Multimedia: Sepsis
References
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Further Reading

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Keywords

sepsis, systemic inflammatory response syndrome, SIRS, septic shock, septicemia, blood infection, bloodstream infection, neonatal sepsis, bacteremia, viremia, fungemia, parasitemia, treatment, diagnosis, symptoms

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Contributor Information and Disclosures

Author

Shankar Santhanam, MD, Consulting Staff, Department of Emergency Medicine, Emergency Medical Associates; Consulting Staff, Department of Family Medicine, Capital Health Systems
Shankar Santhanam, MD is a member of the following medical societies: American Academy of Family Physicians and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Medical Editor

Itzhak Brook, MD, MSc, Professor, Department of Pediatrics, Georgetown University School of Medicine
Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Mark R Schleiss, MD, American Legion Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School
Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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