Infections that occur when microorganisms enter the blood can have serious consequences and children are especially vulnerable. Here, two experts answer questions on these infections.
By Dr Sunil Bhat and Dr Archana M V
Bloodstream infections are some of the most serious forms of infection and are associated with hospitalisation and suffering. Also known as sepsis or blood poisoning, these occur when microorganisms enter the bloodstream and cause organ dysfunction. The microorganisms that cause blood infections could be bacteria, virus, or fungus – but the most common cause is bacteria.
Here, our experts answer a few questions commonly asked about sepsis:
A bloodstream infection can affect any person, at any time. Yet, children, especially newborns, are more vulnerable to it. This is because their immunity levels are low. Apart from that, children, who have not been vaccinated; those below two years of age, whose immune systems has not yet fully developed; and in rare cases, children with immunodeficiency disorders (genetic diseases) are more prone to a bloodstream infection.
Commonly, microorganisms enter the blood through the skin, respiratory tract, gastrointestinal tract or urinary tract. The infection can occur in any part of the baby’s body, like the lungs, bones, joints, abdomen, brain, urinary tract, or the skin. If undetected, blood infection in children can harm organs like the kidneys, liver, brain or even the lungs. It can be fatal, if not diagnosed and treated in time.
A child with a blood infection will have high-grade fever associated with chills and shivering. Other symptoms will depend on the site of infection. Later, the child may develop the following signs:
In a small child:
In older children, sepsis is less common, unless they have a severe infection in some part of the body, like the lungs, bones or brain. The signs to look out for are:
If sepsis is not diagnosed at an early stage, the child may have internal bleeding, a fall in blood pressure or a shutdown of kidney functions.
Normally, the skin acts as a barrier and plays an important role in preventing infections. Any cuts and wounds in the skin could make your child vulnerable to skin infection, which, if not taken care of, could lead to a bloodstream infection. There are a few bacteria residing in the skin called commensals, which can enter the blood through skin wounds and cuts, especially the deep ones, and cause infection.
Certain dermatological conditions like eczema can also interfere with the skin barrier function and cause infection.
When a bloodstream infection is suspected, the child must be admitted in hospital and put through a series of blood tests. There are certain markers (C-reactive protein) which are elevated in sepsis. The confirmatory test is a blood culture that would tell doctors which microorganism is causing the infection and also what medicines can be used to treat it.
Other tests are:
Timely treatment is essential in any suspected case of a bloodstream infection. While the lab tests are awaited, the child has to be given intravenous antibiotics to fight the infection to reduce further damage to the vital organs.
Supportive care is an important part of sepsis management. This includes:
The antibiotic therapy will be modified once the microorganism causing the infection is identified. With appropriate antibiotic therapy and good supportive care, the child will improve in 3–4 days. But, it is important to complete the course of antibiotics and return for follow-up visits.
If the child gets such bloodstream infections repeatedly, it is important to evaluate him for any underlying infection or immunodeficiency disorders.
Prevention is always better than cure. Here are some simple steps to prevent bloodstream infections:
If despite all your care, you notice any signs of sepsis in your child, consult your doctor immediately. If detected early, sepsis can be easily cured.
Dr Sunil Bhat is a director and group clinical lead and Dr Archana M V is a senior fellow, pediatric haematology, oncology and blood and marrow transplantation at a leading hospital in Bengaluru.
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