The dangers of delayed sepsis diagnosis and treatment in children were tragically highlighted in the case of 19-month-old Lilly Reynolds from Portsmouth. In November 2017, Lilly’s family endured a harrowing three-day ordeal as her condition worsened, leading to a critical sepsis diagnosis that could have been prevented with earlier intervention.
The early signs and missed opportunities
Lilly, a previously healthy child with no history of medical issues, first developed a fever and showed signs of erratic breathing and low fluid intake. Her parents sought medical advice by calling 111 on November 4, 2017. The advice given was to visit an out-of-hours surgery, where a GP diagnosed a mild upper respiratory tract infection. Lilly was prescribed paracetamol and ibuprofen, with instructions to seek further medical help if her condition deteriorated.
Though there was slight improvement initially, Lilly’s condition quickly worsened by the following day. She developed a rash on her face, torso, and behind her ears, became lethargic, refused fluids, and had dry nappies. Concerned, her parents took her to the St Mary’s Hospital Walk-in Centre, where she was diagnosed with tonsillitis and prescribed antibiotics. The doctor, however, also consulted Portsmouth’s Queen Alexandra Hospital (QAH), where Lilly was advised to attend for further examination.
At QAH, a consultant ruled out the need for antibiotics, believing the infection was viral. Lilly was discharged later that evening with an open-access 72-hour follow-up, just in case her condition worsened.
The deterioration of Lilly’s condition
Unfortunately, within 24 hours, Lilly’s condition significantly deteriorated. Her parents returned to QAH, where after an initial examination, Lilly was left unattended in her pushchair for several hours. Despite her visible distress, there was little communication from the medical team. At around 2 a.m., a doctor administered a throat spray in an attempt to ease her discomfort, but shortly thereafter, Lilly was sent home with no clear diagnosis.
By midday, Lilly’s condition had worsened further. Her lips turned blue, and her oxygen levels dropped. This prompted a rapid intervention, and Lilly was rushed to the resuscitation room. Broad-spectrum antibiotics were administered, and an x-ray revealed pneumonia and a large buildup of fluid in her lungs. The specialist at Southampton General Hospital (SGH) advised immediate transfer.
A life-threatening situation
Upon arriving at SGH, Lilly’s condition was dire. Her parents were informed that Lilly may lose her leg due to the arterial line placed during her transfer, which had impaired blood flow to her foot. Lilly was later diagnosed with sepsis and pneumonia, and 650ml of fluid was drained from her lungs. The medical team acted swiftly to save her life.
The long-term impact
Though Lilly survived the ordeal, she has been left with lasting health concerns. Her mother, Danielle Barter, expressed the family’s distress: “The whole experience was extremely frightening, and we wouldn’t want any parents to go through what we did. Thankfully, Lilly has recovered from pneumonia and sepsis, but the prognosis for her foot and leg remains uncertain.”
The importance of early sepsis diagnosis
Lilly’s case underscores the importance of early diagnosis and treatment for sepsis. Sepsis, a life-threatening condition caused by infection, is responsible for more deaths in the UK than breast, bowel, and prostate cancer combined. Experts, including Janine Collier, Executive Partner and Head of the Medical Negligence Department at Tees, emphasise the importance of adhering to guidelines issued by the Sepsis Trust and NICE to help healthcare professionals recognise the signs of sepsis early and initiate the correct treatment.
Janine Collier added: “Sepsis is a medical emergency, and early recognition can make all the difference in preventing long-term complications or even death. We will be closely reviewing the facts of Lilly’s case to determine if her treatment was delayed unnecessarily.”
This case serves as a stark reminder of the potential consequences of failing to act on early signs of sepsis, especially in vulnerable children. Early intervention not only saves lives but also maximises the chances of a full recovery without lasting complications.
