Viral Sepsis in Children

Gupta, Neha; Richter, Robert; Robert, Stephen; Kong, Michele

In the pediatric intensive care unit (PICU), influenza virus is a leading cause of viral sepsis and caries an especially high mortality rate (12) . RSV has also been found to cause severe bronchiolitis and may present with sepsis, especially in children with history of premature birth, chronic lung disease, congenital heart disease or primary immunodeficiency (13, 14) . Sepsis has also been observed in neonates with HSV, human parechovirus (HPeV) and enteroviral infection (15) (16) (17) (18) . Patients with immunodeficiency due to human immunodeficiency virus (HIV) infection are highly susceptible to viral sepsis depending on the stage of disease and access and response to the treatment (19) . In these patients, common viral infections observed to cause sepsis include RSV, influenza, parainfluenza, adenovirus, CMV, EBV, and VZV (19) . Diarrheal diseases secondary to viral infections can also lead to sepsis, especially in developing countries (20) . Although rare, rotavirus has been associated with sepsis due to bacterial coinfection (21) . Despite several large studies on viral sepsis in general (ref as above), as well as on specific viruses, in the absence of routine viral testing during the diagnostic evaluation of sepsis, the true incidence of viral infection as the cause of sepsis remains unclear.