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Systemic inflammatory response syndrome (SIRS) and sepsis in children: Definitions, epidemiology, clinical manifestations, and diagnosis

Authors
Wendy J Pomerantz, MD, MS
Scott L Weiss, MD
Section Editors
Susan B Torrey, MD
Sheldon L Kaplan, MD
Adrienne G Randolph, MD, MSc
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

Sepsis is a clinical syndrome that complicates severe infection and is characterized by the systemic inflammatory response syndrome (SIRS), immune dysregulation, microcirculatory derangements, and end-organ dysfunction. In this syndrome, tissues remote from the original insult display the cardinal signs of inflammation, including vasodilation, increased microvascular permeability, and leukocyte accumulation.

Although inflammation is an essential host response, the onset and progression of sepsis center upon a "dysregulation" of the normal response, usually with an increase in both proinflammatory and antiinflammatory mediators, initiating a chain of events that leads to widespread tissue injury. Evidence supports a state of acquired immune suppression or immunoparalysis in some patients, which may occur simultaneously with or following the initial proinflammatory response [1,2]. It is this dysregulated host response rather than the primary infectious microorganism that is typically responsible for multiple organ failure and adverse outcomes in sepsis. (See "Pathophysiology of sepsis".)

Early recognition of sepsis is crucial to ensuring the best outcomes in children and is aided by a working knowledge of the children at particular risk, the common pathogens, and the clinical manifestations. The definition, epidemiology, clinical manifestations, and diagnosis of the systematic inflammatory response syndrome and sepsis in children are discussed here.

The rapid recognition, resuscitation, and initial management of pediatric septic shock and the evaluation and management of undifferentiated shock in children are discussed separately:

(See "Septic shock: Rapid recognition and initial resuscitation in children".)

                         

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Literature review current through: Nov 2016. | This topic last updated: Tue Oct 11 00:00:00 GMT 2016.
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