Viral Sepsis in Children

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

organs that manifests as confusion, nausea, vomiting, diarrhea, oliguria, and coagulopathy. A myriad of cardiopulmonary manifestations ranging from mild tachypnea and tachycardia to acute respiratory distress syndrome and shock can be seen (76) . The presenting symptoms usually depend on the type of virus. Clinical presentation in patients with respiratory viral infections can range from completely asymptomatic to severe respiratory distress due to pneumonia. Diarrheal illness has been observed in patients infected with rotavirus, norovirus, enterovirus, and adenovirus. VZV and HSV infection may present with vesicular rash. Children with HSV or arbovirus infection may have confusion, altered mental status or seizures from encephalitis. Elevated transaminases are common with HSV and enteroviral infections which may be complicated by hepatitis, coagulopathy and encephalitis. Neonatal HPeV infection can mimic other enteroviral infections in the initial presentation. Often these patients present with fever, rash, irritability, feeding intolerance, and seizures (17) . They can develop sepsis like illness and encephalitis. Patients with acute HIV infection often have flulike symptoms such as fever, headache and rash, which usually resolve spontaneously. These patients soon enter a phase of clinical latency until they develop acquired immunodeficiency syndrome, usually heralded by acquisition of an opportunistic infection.