![]() Older children may present with a focus of infection and/or a constellation of features including fever or hypothermia, vomiting, inappropriate tachycardia, altered mental state and reduced peripheral perfusion. Infants and neonates commonly present with non-specific symptoms and signs, such as feeding difficulties and/or apnoea. ![]() recent surgical procedure (within 6 weeks).unimmunised or incomplete immunisation status.children of Aboriginal / Torres Strait Islander / Pacific Islander / Maori origin.14 It is identified by sepsis and cardiovascular organ dysfunction, acknowledging that hypotension is a late sign in children. Septic shock is a subset of sepsis in which profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality. 11-12 The most common type of pathogens are bacteria (viruses and fungi can result in a similar presentation), which vary according to host factors, including age, comorbidity and geographic location. 10 It is a syndrome shaped by both pathogen and host factors. Paediatric sepsis is defined as ‘the systemic inflammatory response syndrome in the presence of, or as the result of, suspected or proven infection’. 8 Early paediatric critical care involvement (onsite or via Retrieval Services Queensland (RSQ)) is essential. Management includes rapid fluid resuscitation, early consideration of inotropes and administration of appropriate antibiotics ideally within the first 15 minutes of presentation. ![]() 1-7 The initial presentation can be vague and non-specific, particularly in neonates, making early diagnosis challenging. 1 The mortality rate for untreated septic shock is more than 80% and even with treatment is estimated at 15-20% in children. Despite advances in prevention and treatment of invasive bacterial infections, sepsis remains a leading cause of childhood morbidity and mortality in Australia.
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