Sepsis in children

#### The bottom line Sepsis is a clinical syndrome resulting from a dysregulated systemic inflammatory response to infection.1 It is characterised by a generalised pro-inflammatory cascade, which may lead to widespread tissue injury.2 It encompasses a clinical spectrum of severity, including severe sepsis, septic shock, and multi-organ failure.3 Sepsis is a leading cause of morbidity and mortality in children worldwide.4 International consensus guidelines define sepsis as the presence of systemic inflammatory response syndrome plus suspected or proven infection.3 A more pragmatic definition of sepsis has been proposed—that sepsis is a systemic response to infection with the presence of some degree of organ dysfunction.5 This definition is not currently widely accepted, but new criteria are under discussion and due to be published later in the year. Global data on sepsis in children are incomplete, but it is estimated that infection accounts for most deaths (almost 60%) in children aged under 5 years.4 The World Health Organization has stated that the four big causes of death in children worldwide are infectious diseases: pneumonia (1.9 million deaths/year), diarrhoea (1.6 million deaths/year), malaria (1.1 million deaths/year), and measles (550 000 deaths/year).6 The largest epidemiological reports of the incidence …