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The Diagnostic and Therapeutic Challenges of Culture Negative Sepsis

  • Pediatric Infectious Disease (M Mitchell and F Zhu, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of Review

This review explores the current literature on the diagnosis and management of pediatric culture negative sepsis.

Recent Findings

We explored logistical factors associated with culture negative sepsis, potential diagnostic tools such as biomarkers, and the limited evidence for treatment of culture negative sepsis in children. In the setting of a negative blood culture, but high clinical suspicion for bacterial infections, clinicians look to biomarkers to help guide the use of antibiotics. These biomarkers, however, are not consistently helpful. In general, procalcitonin is superior to CRP for its specificity of a bacterial infection. However, evidence shows this biomarker may better serve to rule out bacterial infection. Other studies suggest procalcitonin may be used as a method to determine the length of antibiotic therapy, but these protocols have not been standardized. Few studies look at appropriate antibiotic duration for culture negative sepsis but suggest it may be adequate to treat for 5–7 days.

Summary

Overall, culture negative sepsis remains difficult to diagnose and has limited guidance for treatment. This is an important area for future research to help limit the misuse of antibiotics in the era of growing antimicrobial resistance.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Section of Critical Care, Department of Pediatrics, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610, USA

    Kelsey Wehrenberg

  2. Section of Infectious Diseases, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

    Michelle Mitchell

  3. Section of Critical Care, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

    Nathan Thompson

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K.W. wrote the main manuscript text. M.M. and N.T. revised the work critically. All authors reviewed the manuscript and approved the final version.

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Correspondence to Kelsey Wehrenberg.

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Wehrenberg, K., Mitchell, M. & Thompson, N. The Diagnostic and Therapeutic Challenges of Culture Negative Sepsis. Curr Treat Options Peds (2024). https://doi.org/10.1007/s40746-024-00293-6

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