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Complications of Sepsis in Infant. A Case Report
Lorena Elena Meliț1, Cristina Oana Mărginean2, Anca Georgescu3
1Pediatrics Clinic 1, County Clinical Emergency Hospital, Craiova, Romania.
Insights
Sepsis in infants presents with non-specific symptoms. This case highlights Staphylococcus aureus septic arthritis in an infant, emphasizing the need for prompt diagnosis and tailored antibiotic therapy for effective treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Sepsis, a systemic inflammatory response, presents with diverse symptoms in infants.
- Early diagnosis and treatment are crucial for managing sepsis in pediatric patients.
- Trauma can be a predisposing factor for infections in infants.
Purpose of the Study:
- To present a case study of Staphylococcus aureus septic arthritis in an infant.
- To illustrate the diagnostic challenges and treatment evolution for pediatric sepsis.
- To highlight the importance of adjusting antibiotic regimens based on clinical response.
Main Methods:
- Case report of an eight-month-old infant with fever and suspected sepsis.
- Clinical examination, laboratory tests (leukocytosis, ESR, CRP), and blood cultures.
- Imaging (CT scan) for diagnosis, surgical drainage, and antibiotic therapy adjustments.
Main Results:
- The infant presented with fever, leukocytosis, and elevated acute phase reactants.
- Blood cultures confirmed Staphylococcus aureus (MSSA) infection.
- Septic arthritis of the knee was diagnosed via CT scan, requiring drainage and modified antibiotic treatment (Oxacillin).
Conclusions:
- Sepsis in infants is complex, with nonspecific symptoms and unpredictable progression.
- Effective management requires vigilant monitoring and adaptable antibiotic strategies.
- Prompt diagnosis and intervention, including surgical management when necessary, are vital for favorable outcomes.
Abstract:
Sepsis is a systemic inflammatory response (SIRS) characterized by two or more of the following: fever > 38.5 °C or <36 °C, tachycardia, medium respiratory frequency over two SD for age, increased number of leukocytes. The following is a case of an eight months old, female infant, admitted in to the clinic for fever (39.7 C), with an onset five days before the admission, following trauma to the inferior lip and gum. Other than the trauma to the lip and gum, a clinical exam did not reveal any other pathological results. The laboratory tests showed leukocytosis, positive acute phase reactants (ESR 105 mm/h, PCR 85 mg/dl), with positive blood culture for Staphylococcus aureus MSSA. at 24 hours. Three days from admission, despite the administration of antibiotics (Vancomycin+Meronem), there was no remission of fever, and the infant developed a fluctuant collection above the knee joint. This was drained, and was of a serous macroscopic nature. A decision was made to perform a CT, which confirmed the diagnosis of septic arthritis. At two days after the intervention, the fever reappeared, therefore the antibiotic regime were altered (Oxacillin instead of Vancomycin), resulting in resolution of the fever. Sepsis in infant is a complex pathology, with non-specific symptoms and unpredictable evolution.
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