16/01/2026
Severe bacterial infection or sepsis is diagnosed in any child with fever or hypothermia who is severely unwell with any of the following features:
1– General appearance and behaviour:
reduced activity, poor feeding, no smile, unfocused gaze, unresponsive stare, hypotonia, decreased response to stimuli, lethargy, weak or highpitched cry.
2– Colour:
mottled appearance, ashen, blue, or pale skin color.
3 – Breathing:
difficulty breathing (dyspnoea, tachypnoea, grunting, chest indrawing, nasal flaring) or apnoea
4– Circulation and hydration:
dry mucous membranes, persistent tachycardia despite reduction in fever, central CRT > 3 seconds, weak pulse, cool extremities, reduced skin turgor, reduced urine output.
5– Neurological:
neck stiffness, bulging fontanelle, focal neurological signs, prolonged seizures.
6 – Other:
fever for more than 5 days; presence of a non-blanching rash (i.e. petechiae or purpura).
