Pediatric - sepsis

Dear Ask The Doctor: My two month old male child developed fever for seven days and on 7th day developed few episodes of mild fits ( shaking either of his hands), was admitted in hospital (for 12 days), was given gardenal,epsolin as IV injection for 3 days and changed to phenydin, gardenal as oral drops for rest of the days by neurologist. Besides this, pedriatrician were giving piptaz, amikacin, fortum, ranindine, azom, targocid as IV injection with digene and zincovit syrups for all those days. no recurrence of seizures and fever post admission to hospital till 5th day. then low grade of fever recurred regularly. my child was kept in CCU for first 3 days and shifted to pediatric ward ( which was unhygienic), fever spiked 2 days after that shift, as we suspected it as cross infection shifted to seperate room, my child developed mild petechia and on 8th day stomach distention with heptopsplenomegaly and on 13th day developed tachycardia and tachypnea and was cyanosed with poor pulses. when started CPAP developed massive pulmonary bleed . child had profuse tracheal bleed and pulseless activity and cardiac arrest. CPR done and child resuscitated. started with adrenaline and dopamine IV infusion. blood, cryoprecipitate and platelet transfusion given. Blood gas showed severe metabolic acidosis and chest x-ray showed white out lungs. Echo showed dilated left ventricle with moderate dysfunction and ejection fraction of 40%. dobutamine was started.my child continued with very poor prognosis and withing few hours died. We were not educated about the critical condition of the child, before it happen. still now we were not given solid dianogsis, suspected to be sepsis. Will this sudden outcome emerge overnight or all of a sudden? did the treatment was in the right direction? why this sudden death occured? kindly answer me as my heart aches of pain and tears.

Dear Kavitha:

I am very sorry about your recent loss and I also understand how concerned you are about the course of your baby’s condition.

After reading your description of the events, in my opinion, I might agree with the diagnosis of sepsis that you were told. As you may already know, Sepsis is a life threatening condition in which the immune system's reaction to an infection may injure body tissues far from the original infection causing a multiple organ failure.

As sepsis progresses, it begins to affect organ function and eventually can lead to septic shock a sometimes fatal drop in blood pressure. Unfortunately sepsis is more dangerous in very young and old people. Certainly in infants without a good and well developed immune system it can progress easily if treatment is not given early.

Treatment with wide spectrum antibiotics must be initiated early and then switched to a specific type of antibiotic for the specific pathogen causing the infection. Apparently your baby was given the treatment as early as possible but I can’t give an opinion since I can’t see his lab results. You could discuss this with more detail with the physicians that treated your son. I understand your pain and wish you the best.