Viral Sepsis in Children

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

Sepsis is a leading cause of pediatric mortality (1) . Defined as systemic inflammatory response syndrome in the presence of a suspected or confirmed infection, it is a clinical syndrome principally characterized by dysregulation of the host innate immune response and may result in an immune phenotype of coexistent systemic inflammation and immunosuppression (2) . Pathological crosstalk between inflammatory and coagulation cascades, complement activation, and neuroendocrine signals wreak havoc on homeostatic controls. This hyperinflammatory response has untoward effects on the cardiopulmonary system, vascular endothelium, and gut, precipitating progressive organ dysfunction until the host succumbs (3) . The morbidity, mortality, and costs associated with pediatric sepsis impose a significant burden on the healthcare community and global economy (4, 5) . Watson et al reported a mean hospital length of stay of 31 days, with approximately $2 billion spent annually in healthcare cost associated with severe pediatric sepsis (1) . International guidelines for management of sepsis and septic shock stress the importance of rapid resuscitation, prompt antimicrobial administration, and supportive care of organ dysfunction as the mainstays of pediatric sepsis treatment (6) .