Sepsis-Induced Cardiomyopathy Secondary to Escherichia coli Sepsis and Intestinal Perforation: A Diagnostic Challenge in a Paediatric Patient

A five-year-old male presented with abdominal pain, fever, vomiting, and constipation. Initial investigations suggested subacute intestinal obstruction. Laparotomy revealed intestinal perforation with peritonitis due to <i>Escherichia coli</i>. Post-operatively, the patient developed sepsis-induced cardiomyopathy (SICM), requiring inotropic support and mechanical ventilation. The complex clinical presentation and overlap of symptoms with septic shock delayed the diagnosis of SICM, making timely identification challenging. This case highlights the diagnostic challenges in identifying sepsis-induced cardiomyopathy in the context of severe sepsis and abdominal pathology, underscoring the need for early recognition, particularly using echocardiography for myocardial dysfunction assessment.