Gupta Neha, Richter Robert, Robert Stephen, Kong Michele
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States.
Division of Pediatric Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Front Pediatr. 2018 Sep 18;6:252. doi: 10.3389/fped.2018.00252. eCollection 2018.
Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although viruses may be important causative agents of culture-negative sepsis worldwide, the incidence, disease burden and mortality of viral-induced sepsis is poorly elucidated. Consideration of viral sepsis is critical as its recognition carries implications on appropriate use of antibacterial agents, infection control measures, and, in some cases, specific, time-sensitive antiviral therapies. This review outlines our current understanding of viral sepsis in children and addresses its epidemiology and pathophysiology, including pathogen-host interaction during active infection. Clinical manifestation, diagnostic testing, and management options unique to viral infections will be outlined.
儿童脓毒症在未得到其他证明之前通常被假定为细菌源性,但细菌培养结果往往最终呈阴性。尽管病毒可能是全球范围内培养阴性脓毒症的重要致病因素,但病毒所致脓毒症的发病率、疾病负担和死亡率仍未得到充分阐明。考虑病毒脓毒症至关重要,因为对其的认识关系到抗菌药物的合理使用、感染控制措施,以及在某些情况下特定的、对时间敏感的抗病毒治疗。本综述概述了我们目前对儿童病毒脓毒症的认识,并探讨其流行病学和病理生理学,包括活跃感染期间病原体与宿主的相互作用。还将概述病毒感染特有的临床表现、诊断检测和管理选项。