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Neuropathologic Autopsy Findings in Pediatric Sepsis: A Two-Center, Retrospective Study.

Alicia M Alcamo1,2,3, Leora Lieberman1, Nora Sherry4

  • 1Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|December 31, 2025
PubMed
Summary
This summary is machine-generated.

Sepsis frequently causes brain damage, with most patients showing acute neuropathological findings. Further research is crucial to develop effective treatments for sepsis-induced brain injury.

Keywords:
acute brain dysfunctionneuropathological autopsypediatric sepsisseptic encephalopathy

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Area of Science:

  • Neurology
  • Pathology
  • Pediatrics

Background:

  • Sepsis is a life-threatening condition associated with significant morbidity and mortality.
  • Acute brain dysfunction is a common complication of sepsis, but its underlying pathophysiology remains poorly understood.
  • Limited data exist on the specific neuropathological changes occurring in children with sepsis.

Purpose of the Study:

  • To investigate the neuropathological findings in children who died from sepsis.
  • To identify common gross and microscopic brain abnormalities associated with sepsis in a pediatric population.
  • To explore potential correlations between clinical factors and neuropathological outcomes.

Main Methods:

  • Retrospective cohort study involving two large children's hospitals.
  • Analysis of neuropathological autopsy data from pediatric sepsis cases over a ten-year period.
  • Review of gross and microscopic examination findings of the central nervous system (CNS).

Main Results:

  • Of 57 sepsis patients, 86% exhibited at least one acute neuropathological finding.
  • Common findings included cerebral edema (39%), ventriculomegaly (39%), hemorrhage (30%), neuronal injury (45%), and infarction (25%).
  • Premortem CNS infections were associated with edema, while absence of comorbidities correlated with edema and neuronal injury.

Conclusions:

  • Neuropathological abnormalities are prevalent in pediatric sepsis cases.
  • Understanding these pathologies is essential for developing targeted interventions.
  • Further studies are needed to elucidate the mechanisms of sepsis-related brain injury and inform treatment strategies.