Related Experiment Video

Updated: Jul 15, 2026

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
08:46

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

Published on: August 12, 2020

Hypoglycemia in bacterial septicemia

Ian Preyra1, Andrew Worster

  • 1Division of Emergency Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada.

CJEM
|May 3, 2007
PubMed

Insights

Severe hypoglycemia, not hyperglycemia, can be the first sign of meningococcal sepsis in children. This case highlights the importance of considering unusual presentations for timely diagnosis and treatment of sepsis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Endocrinology

Background:

  • Severe bacterial infections, or sepsis, commonly cause hyperglycemia in emergency departments.
  • Hypoglycemia is an atypical presentation of sepsis in pediatric patients.
  • Delayed diagnosis of sepsis can occur when hypoglycemia is the initial symptom.

Purpose of the Study:

  • To report a case of severe hypoglycemia as the primary presentation of meningococcal sepsis in a pediatric patient.
  • To discuss the pathophysiology of glucose metabolism disturbances in sepsis.
  • To emphasize the need for considering sepsis in pediatric patients presenting with severe hypoglycemia.

Main Methods:

  • Case report of a 14-year-old male presenting to the emergency department.
  • Clinical assessment and diagnostic workup for sepsis and hypoglycemia.
  • Review of literature on glucose homeostasis in sepsis.

Main Results:

  • The patient presented with severe hypoglycemia and constitutional symptoms.
  • The hypoglycemia was the initial indicator of overwhelming meningococcal sepsis.
  • The case illustrates a deviation from the typical hyperglycemic response in sepsis.

Conclusions:

  • Severe hypoglycemia can be an initial manifestation of meningococcal sepsis in children.
  • Clinicians should consider sepsis in pediatric patients with unexplained severe hypoglycemia.
  • Prompt recognition and management are crucial for improving outcomes in pediatric sepsis.

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...