Pediatric Infectious Disease

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VOLUME 1 , ISSUE 4 ( October-December, 2019 ) > List of Articles


Sepsis Mimics

Santosh T Soans, Sahana Panambur

Keywords : Diabetic ketoacidosis, Inborn errors of metabolism, Kawasaki, Macrophage activation syndrome, Sepsis mimic

Citation Information : Soans ST, Panambur S. Sepsis Mimics. Pediatr Inf Dis 2019; 1 (4):145-147.

DOI: 10.5005/jp-journals-10081-1217

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2019; The Author(s).


Mimics of sepsis are a common cause of misdiagnosis in the emergency department. Studies have shown that more than 50% of patients identified and treated for severe sepsis have negative culture results. Of the patients identified with a sepsis syndrome at presentation, 18% have a noninfectious disease that mimics sepsis. Hence, it is important to differentiate sepsis from several noninfectious diseases that may closely mimic sepsis. Conditions such as diabetic ketoacidosis (DKA), Kawasaki disease (KD) shock syndrome, pancreatitis, and inborn errors of metabolism (IEM) mimic the clinical presentation of sepsis, while anaphylaxis, adrenal insufficiency, hemorrhage, pulmonary embolism, and spinal cord injury mimic the hemodynamic parameters of sepsis. Due to a significant overlap in the clinical, hemodynamic, as well as laboratory parameters, sepsis and its mimics are often not distinguishable on the initial assessment. Unresolving sepsis with appropriate fluid resuscitation and antimicrobials may be a clue that it is not sepsis alone. High index of suspicion combined with a systematic approach and prompt therapy is important as many can be progressive and fatal. Nonetheless, sepsis is still the commonest. Beware mimics are there but rare!!

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  1. Long B, Koyfman A. Clinical mimics: an emergency medicine – focused review of sepsis mimics. J Emerg Med 2017;52(1):34–42. DOI: 10.1016/j.jemermed.2016.07.102.
  2. Lagi A, Cencetti S. Clinical sepsis mimic. J Gen Med Prim Care 2017;1(1):100004.
  3. Boushra MN, Miller SN, Koyfman A, et al. Consideration of occult infection and sepsis mimics in the sick patient without an apparent infectious source. J Emerg Med 2019;56(1):36–45. DOI: 10.1016/j.jemermed.2018.09.035.
  4. Cunha BA. Sepsis and its mimics. Intern Med 1992;13:48–55.
  5. Jones AE, Heffner AC, Horton JM, et al. Etiology of illness in patients with severe sepsis admitted to the hospital from the emergency department. Clin Infect Dis 2010;50(6):814–820. DOI: 10.1086/650580.
  6. Cunha BA. Sepsis and its mimics in the critical care unit. Infectious Diseases in Critical Care Medicine 2007;2:73–78.
  7. Cunha BA, Shea KW. Fever in the intensive care unit. Infect Dis Clin North Am 1996;10(1):185–209. DOI: 10.1016/S0891-5520(05)70294-4.
  8. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 2017;43(3):304–377. DOI: 10.1007/s00134-017-4683-6.
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