However, sepsis also causes similar response to SIRS. Microbial factors
Bacterial virulence factors, such as glycocalyx and various adhesins, allow colonization, immune evasion, and establishment of disease in the host. Sepsis caused by gram-negative bacteria is thought to be largely due to a response by the host to the lipid A component of lipopolysaccharide, also called endotoxin. Sepsis caused by gram-positive bacteria may result from an immunological response to cell wall lipoteichoic acid. Bacterial exotoxins that act as superantigens also may cause sepsis. Superantigens simultaneously bind major histocompatibility complex and T-cell receptors in the absence of antigen presentation. This forced receptor interaction induces the production of pro-inflammatory chemical signals (cytokines) by T-cells.There are a number of microbial factors that may cause the typical septic inflammatory cascade. An invading pathogen is recognized by its pathogen-associated molecular patterns (PAMPs). Examples of PAMPs include lipopolysaccharides and flagellin in gram-negative bacteria, muramyl dipeptide in the peptidoglycan of the gram-positive bacterial cell wall, and CpG bacterial DNA. These PAMPs are recognized by the pattern recognition receptors (PRRs) of the innate immune system, which may be membrane-bound or cytosolic. There are four families of PRRs: the toll-like receptors, the C-type lectin receptors, the NOD-like receptors, and the RIG-I-like receptors. Invariably, the association of a PAMP and a PRR will cause a series of intracellular signalling cascades. Consequentially, transcription factors such as nuclear factor-kappa B and activator protein-1, will up-regulate the expression of pro-inflammatory and anti-inflammatory cytokines. Host factors
Upon detection of microbial antigens, the host systemic immune system is activated.
Psychological and social development
Of the two major socializing agents in childrens lives: the family environment...and formal educational institutions, it is the family in its function a primary socializer of the child that predominates in the first five years of life: middle childhood by contrast is characterized by a childs readiness for school...being self-assured and interested; knowing what kind of behavior is expected...being able to wait, to follow directions, and getting along with other children.Preadolescent children have a different view of the world from younger children in many significant ways. Typically, theirs is a more realistic view of life than the intense, fantasy-oriented world of earliest childhood. Preadolescents have more mature, sensible, realistic thoughts and actions: the most "sensible" stage of development...the child is a much less emotional being now. They will often have developed a sense of  intentionality. The wish and capacity to have an impact, and to act upon that with persistence; and will have a more developed sense of looking into the future and seeing effects of their actions (as opposed to early childhood where children often do not worry about their future). This can include more realistic job expectations ("I want to be an engineer when I grow up", as opposed to "I want to be a wizard").