Viral Sepsis in Children

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

End-organ failure is a major contributor to mortality in sepsis and septic shock, including virus-induced sepsis. Complications such as acute respiratory distress syndrome, disseminated intravascular coagulation, and acute renal injury often leads to a worse prognosis. Developing countries often have disproportionately higher mortality in patients with viral infections (190) , likely due to delayed diagnosis and treatment. Risk of severe sepsis is also related to the site of infection, with endocarditis and CNS infections being associated with mortality as high as 20% (1) . Besides the site of infection, the type of virus also determines the risk of mortality. For example, meningitis from HPeVs is a common cause of sepsis in neonates and young children but consequent mortality is low in these patients (179) . HPeV3 is associated with more severe disease than HPeV1 (113) . Moreover, the extent of systemic involvement can predict the development of multiple organ failure and thus mortality (191) . Sepsis related mortality has been reported in other viral infections including dengue fever (192) . However, further studies are necessary in order to estimate the burden of viral sepsis on outcomes including morbidity, mortality, and health care related costs.