Consultant pediatrician at Cambridge University NHS Trust in the UK. A child doctor specializing in brain development and neurology. She has three children.
Sepsis is the body’s response to an infection. The body senses the presence of an infection, and the immune system responds in an overwhelming way which begins to cause damage to its own tissues and organs. Unchecked, sepsis (sometimes called septicaemia and septicemia) can lead rapidly to organ failure and death.
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In Short
If your baby has any of the following symptoms, or if you feel they're "not right", get to A&E or call an ambulance:
High temperature (or very low)
Listless
Non-blanching rash
Unhappy with light
Crying a lot
Not feeding
Limp, unresponsive
Sunken fontanelle
Rapid shallow breathing
Mottled, pale or blotchy skin
Dry nappies longer than 12 hours
Meningitis or sepsis?
Tilly was just 7 months old when she was left fighting for her life because of sepsis.
Tilly in intensive care
Tilly’s the little girl on the left. Now 3, she is enjoying a healthy and happy life with her identical twin sister.
Tilly with her twin sister
But it could have been so different….
Her Mum describes how she was suddenly living every parent’s nightmare, and how she had to act to save her daughter’s life.
In April 2009, all 4 girls caught chicken pox consecutively. They were aged 4 yrs, 2yrs and the twins were 7 months. Each girl got it worse than the one before and Tilly was the last to catch it. Her sister, Lucy, had developed a secondary infection in one of her spots and been prescribed antibiotics, so I was not too alarmed when Tilly also got a spot on her chest that looked quite angry.
Typically, it was a bank holiday weekend, and that night Tilly was very unsettled and would not feed. She was crying constantly and had a high temperature. We took her to an out-of-hours doctor, who prescribed antibiotics and sent us home. The doctor did not even take Tilly out of the buggy to examine her. Ironically, the out-of-hours clinic was actually within the hospital and it would have been very easy for her to get Tilly seen by a paediatrician. By this time, the redness was streaking up in a line from her spot which looked highly suspicious to me the doctor really didn’t take any time to assess her.
By the time I got her home, she had become limp and unresponsive, so we rushed her back to the local hospital Emergency Department. She was immediately admitted and given IV antibiotics and fluids. After 24 hours, she had stopped passing water completely despite having received 2000ml of fluid. She was completely swollen and it was difficult to get any lines in her. She had gone from weighing 7kg to 9kg in 24 hours! A non-blanching rash appeared, and it was at this point I started to really panic.
I insisted they got a consultant in (it was 2:00 am on Easter Monday and we had lost all faith in the Registrar- we just wanted the best for our daughter!). As soon as the Consultant arrived it was decided that Tilly needed to be transferred to a specialist centre. While waiting for the retrieval team from the regional PICU (Paediatric Intensive Care Unit), she was put on an inotropic support (drugs to support her low blood pressure) on the children’s ward. At 5:00 am, the PICU team arrived and I have never been so relieved to see such an army of doctors and nurses in all my time! She was intubated (a tube was placed into her windpipe to support her breathing), a central line (a catheter placed in a large vein in the neck to monitor and give drugs) was put in and she was whisked away. We live 70 miles from the PICU so it was a tough journey, and we also had to arrange what to do with the other 3 girls!!
However terrifying it was to see her in PICU, it was also a huge relief knowing she was in the best hands. They grew Strep A (a form of Streptococcus) from the pus that they drained from her chest wall and she was put on the appropriate antibiotics. The whole nightmare was to continue as they did CT scans, MRI scans, lumbar punctures etc to see if they could find a cause for seizures which she developed later. After 7 days she was extubated and then we returned to our local hospital for a further 8 days of antibiotics and to wean her off the morphine. I was amazed at how quickly she bounced back and I realise how very lucky we were for her to have survived without any major issues.
It was, from this point, that her development seemed to be delayed, and looking back at what she went through it is hardly surprising.
Although her development is within the normal limits, she is a long way behind her identical twin Lucy. Cognitively, she has struggled with even the most basic concepts (colours, counting etc) but she gets there eventually so I am not overly concerned. I would say she tends to do things/ get concepts about 6 months later than Lucy. Her speech is still fairly basic, whereas Lucy is talking in quite complicated sentence structures with a good vocabulary. She walked 4 months later than Lucy, but the physical milestones now seem less significant as they are now on a par in that respect. They are due to start school in September, and I suppose it is the first time I have really had to evaluate the impact of Tilly’s illness.
Dr Ron Daniels, Chair of the UK Sepsis Group explains:
Tilly was one of the lucky ones. Sepsis can be more subtle than the meningococcal disease, but is every bit as deadly. In fact, most deaths from the meningococcal disease are actually due to the sepsis it causes, and the typical rash we all fear can occur in sepsis due to other bugs too. Tilly’s illness was caused by a bacterium called Streptococcus, which is the most common serious infection in newborn babies, but many other bacteria can cause the illness.
Sepsis is the body’s response to an infection. The body senses the presence of an infection, and the immune system responds in an overwhelming way which begins to cause damage to its own tissues and organs. Unchecked, sepsis can lead rapidly to organ failure and death.
Every parent knows when their child is ‘not right’. As Tilly’s Mum’s story illustrates if as a parent you suspect your child may be seriously unwell it’s essential you say so, even if they are already in a hospital or at the Surgery. Tilly’s signs were typical of an unwell infant- she wasn’t feeding, was crying constantly and had a high temperature. Later, she became limp and unresponsive, and her Mum was absolutely right to rush her back to the hospital.
If a newborn baby or infant has two or more of a very high (or very low) temperature, a sunken fontanelle (‘soft spot’), rapid shallow breathing, or is either listless and lethargic or crying inconsolably then they may have sepsis. You should seek medical advice if you are at all concerned.
In the early stages, it is often difficult to distinguish sepsis from a minor viral illnesses which are common in babies. However, If any of the features above exist and your baby’s skin is cold, pale or has developed strange colours or markings (‘mottled’), if (like Tilly did) she becomes pale and unresponsive or has had dry nappies for more than 12 hours then you should take her to hospital without delay.
Note
Sepsis is a medical emergency. Caught early, the outlook is good for the vast majority of babies and children. It is crucial not to delay seeking medical attention.
Please visit the Sepsis Trust for more information.
DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.
