I suspect sepsis - have I been fobbed off?

[teamaven]

I called an ambulance for my 5 year old daughter this morning (who is never ill and I’ve never phoned an ambulance so to me it was serious). She woke up at 1:30am screaming and crying that her lower left side hurt. She said she couldn’t move and wouldn’t settle all night despite us thinking she’ll be fine and trying to go back to sleep - then started complaining of a headache at the back of her head and her temp went up to 39.9.

She was extremely hot to the touch, a bit confused and lethargic so I panicked and called an ambulance. After an hour of Neurofen her temp went down to 38.4 and stayed like that for a couple of hours.

I suspected a urine infection (possibly that had developed into sepsis!) because she has had one before and her pull up (she’s still in them at night) was so heavy and absolutely reeked. Her urine test showed signs of infection so the doctor agreed it was probably an infection that had travelled up.

Now, I did ask him to do a blood test anyhow and he said it wouldn’t show anything, but would it not show how bad the infection is ie sepsis? He sent us home with 10 days oral antibiotics and daughter is asleep now but I’m scared that based on her symptoms it was much worse than just a urine infection? The very high temp, lethargy, confusion, headache?

Can anyone provide what the usual pathway is when a child comes in with those symptoms? I feel like we shouldn’t have been sent home - at least to be observed over a few hours?

Hello @teamaven, I hope the antibiotics have worked their magic and your little one is starting to feel better.

Thanks everyone. My main reason for thinking it was something that could have turned septic (I kinda knew it was a UTI from the smell of her urine alone) is because of the high fever, confusion and I didn’t mention in the post but she was also shivering and saying she was freezing.

Anyway her temp finally went down to normal yesterday, she’s a bit better in herself but still in a lot of pain. She started the antibiotics Saturday morning so if she’s still in pain tonight I will take her back to A&E.

It is definitely worrying seeing your child who usually is a tough cookie deteriorate so fast and be in so much pain. I just didn’t want to be one of those stories where the doc sends them home in that condition and they end up dead - sorry extreme but unfortunately it happens

A&E isn’t the right place for her now. If you are still concerned when she has finished her course of antibiotics then make an emergency appointment with your GP.

Did she get anything for the pain? Whenever my children had a particularly painful illness they always got prescribed pronaxen which is a really effective long lasting anti-inflammatory

She doesn't need A and E now, it's to be expected she'll have some pain still. Are you giving her regular painkillers?

This. Get her seen this afternoon.
I fully agree with not messing about with urine infections - this is what finished my poor gran off even though she was already very ill. But sitting for hours in A&E isn't necessarily the right pathway.

Sounds like she needs more pain meds rather than a&e. Give your doctor a ring or fill in the form online and let them triage her. They can possibly up the dosage on her current pain med (calpol) or give her something stronger.

Why on earth is A&E tonight your next step? She’s improving, if she starts deteriorating again then that may be an emergency. Otherwise, it’s a GP practise matter.

If a thought starts with ‘if it’s still…. by tonight’ then the tonight action isn't A&E.

A&E isn’t for UTIs. If she stops improving then GP in the morning and ask them to send a urine sample off to check she’s on the right antibiotic. But she has several days of medication left and pain is to be expected with a UTI. Depending on where it is you can ask for more pain relief, or do home remedies like a sitz bath. I sympathise because they’re horrible infections but not an emergency unless rapidly deteriorating

I don’t think you can say A&E is never for utis. Depends on the severity of the uti.

If she’s improving on the antibiotics and it sounds like she is this sounds more like a GP issue now though.

The very first time I had a UTI I called NHS24 (as it was back then) and they told me to go to A&E (who then directed me to minor injuries tbf) as it was the middle of the night and I was unable to wee at all so was in agony. They even offered to send an ambulance for me when I said I wasn't sure how I was going to get there as I was a student with no money to spare for a taxi (but of course I said no and got a friend to split the cost with me)

2 doctors at A&E told me to bring her back there if she still had pain after today

2 different A&E doctors told me to bring her back if she still had pain after 48 hours (as if it is a UTI the antibiotics should have kicked in) to investigate other stomach issues. She cannot stand or walk she is in so much pain, if it was a gradual or minor issue yes absolutely GP

I would still take her to the GP if she has finished het course of antibiotics as he will be the one following her up if she needs it.
Your GP can also refer her directly to the hospital if she needs it.

If A&E doctors told you to take her back if she's still in pain then do so, they might want to scan her abdomen if they think she's not improving. Just be prepared for a long wait as she won't be as high priority.

I disagree with a lot of posters here actually UTIs can be very dangerous? Especially in younger children as it’s not as common for them to get them.

I have an abnormal urinary tract and get a lot of UTIs and I am always told if I feel shivery, sick, have a high fever to go to A&E, they can move up to your kidney. If she still feels ill and has stomach pain have they ruled out a kidney infection? She may not be on the correct antibiotic for the infection, this has also happened to me several times, did they take a sample?

That’s awful op yes take her back.

What a stupid advice. GP can’t urgently investigate any issues, and there are no more direct urgent referrals that skip the A&E queue

I really wish people would stop telling posters not to go to A&E - a vulnerable, scared person is going to listen to that and wind up dead, or with a dead child one day.

I would take her back in accordance with their advice. Children that age generally are quite stoic and bounce back quickly after a couple of days antibiotics, I think it’s a bit of a red flag if she cannot walk due to the amount of pain she’s in - that’s really not normal at all.

Just go to A&E, just get her seen. If she was my child I wouldn't care what anyone else thought, if I was worried, I would get her seen. Its not normal shes in so much pain that she cant walk. Please dont listen to the posters.

I work on a Children's Ward and GP’s refer directly to the ward (therefore bypassing A&E). They will be admitted to the ward for diagnosis, treatment and follow up.
If she is in extreme pain then A&E would be appropriate.

Took me 3 times going to a&e to get the help I needed, ive been in hospital since Saturday. Always trust your gut, you know when something isnt right

How is she getting to the toilet? Can she genuinely not weight bear, or is she just finding it hard to walk around?

If she's unable to weight bear I would take her back.

I’m sure this isn’t the case with you but my 7 year old had exactly the same symptoms and it turned out to be leukaemia. Push for the blood test to rule out anything serious. He’s doing well now and cancer free.