Application of the Phoenix Sepsis Score for Diagnosing Sepsis in Children with Measles

Objective: To assess the prevalence of sepsis and septic shock in children with complicated measles using the Phoenix Sepsis Score Criteria (PSSC) during the first 24 hours of admission to the Infectious Diseases Intensive Care Unit (IDICU). Methods: This prospective observational cohort study was conducted in the IDICU at Children’s Hospital 1, Ho Chi Minh City, Vietnam, from June 2024 to December 2024. The study included 161 children aged 1 month to 16 years with measles-associated complications. Results: A total of 161 cases, with a median age of 9 months (IQR: 6–21), were included. Among them, the 49.7% were infants under 9 months. The male-to-female ratio was 1.99:1. Malnutrition was present in the 45% of patients. Other comorbidities included preterm birth (22%), cyanotic congenital heart disease (3.7%), chronic lung disease (3.1%), and thrombocytopenia (2.4%). The prevalence of sepsis was 30.4% (n=49), with 24.5% of these cases progressing to septic shock, representing the 7.5% of the total cohort (12/161). Median age was higher in the sepsis group (19 months, IQR: 7–50) compared to non-sepsis (8 months, IQR: 5.5–12.5). Malnutrition was more prevalent among septic patients (63.3% vs. 36.6%). Children with sepsis required invasive respiratory support more frequently (55.1% vs. 2.7%), experienced longer hospitalizations (8 days, IQR: 6–12 vs. 6 days, IQR: 5–8), and had higher mortality (6.8% vs. 0%). All three deaths occurred in septic patients. Respiratory criteria were predominant in children with a Phoenix Sepsis Score ≥1. Conclusions: The prevalence of sepsis and septic shock in children with complicated measles was 30.4% and 7.5%, respectively. Clinical factors including age, sex, and nutritional status were significantly associated with sepsis. Children with sepsis required more invasive respiratory support, had longer hospital stays, and experienced higher mortality.