A
Good question. I couldn’t find a large, recent study that says exactly what percentage of children with later‑proven sepsis are afebrile on presentation**, but there are some relevant data and caveats:
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In a classic study of bacteremia in children, 13% of bacteremic children were afebrile (temp < 37.8 °C) on presentation. (Lippincott Journals)
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In infants ≤ 90 days old (with a history of fever), a prospective study found 2.4% of those afebrile on arrival had an invasive bacterial infection (IBI, including sepsis) – the same proportion as febrile infants in that cohort. (PubMed)
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A review article also notes that up to 13% of bacteremic children present without fever. (clinician.com)
Summary / interpretation:
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Roughly 10–13% of bacteremic / septic children may present without a fever, based on older and focused studies.
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However, the exact percentage depends a lot on age (e.g., neonates vs older children), definitions (sepsis vs bacteremia), and the study population.
If you tell me which age group you mean (e.g. newborns, toddlers, all children) and whether by “sepsis” you mean confirmed bacteremia or invasive bacterial infection, I can try to give a more precise figure.
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