Peds S- Sepsis and Serious Bacterial Infections

Pediatric “Sepsis” * Consider in any toxic appearing child/neonate* Especially with fever (or hypothermia)* Treatment* Early antibiotics* Fluid bolus “Serious Bacterial Infections” (SBI) * Consider in any baby with fever* Three classic categories* Age <30 days* Introduction* Weak immune system* No immunizations* Very high risk for serious bacterial infections* Require a significant amount of testing* Urinalysis with Urine Culture* Blood Cultures* Lumbar Puncture with CSF Cultures* Chest X-Ray* Require admission and antibiotics* Age 30-60 days* ILL appearing* Treat same as fever in <30 day patient* WELL appearing* Testing and treatment differ by institution* Multiple criteria established to help in this age range* Rochester criteria* Philadelphia criteria* PECARN criteria* Choose one and use consistently* Age >60 days* (Assumes immunizations are up to date)* Workup is more targeted* Blood cultures, Urine cultures, Chest X-Rays still common Additional Reading * Rochester Criteria Febrile Infants (MDCalc)* PECARN Rule for Low Risk Febrile Infants (MDCalc)