Early lipid disturbances persisted for3-days in both, the septic and the traumatic metabolic pattern. First 3 days distribution of a) C-reactive protein (CRP), b) procalcitonin (PCT), c) glucose (GL), d) triglycerides (TG), e) low- (LDL) and f) high-density-lipoproteins (HDL) in healthy children and in patients with systemic inflammatory response syndrome (SIRS) after Traumatic Brain Injury (TBI), sepsis (S), or severe sepsis (SS). The 3-day follow up showed a significant longitudinal decrease of PCT in septic patients followed by parallel decreases of HDL and increases of TG in the SS group. CRP changes in TBI and S groups were not reflected by similar changes in any of the metabolic indices (differences shown by horizontal lines). Pathologic metabolic patterns were distinct in the sepsis and TBI groups compared to controls and all early (first 6-hours) HDL and TG differences between S or SS and TBI persisted throughout the first 3 days (p < 0.04); LDL day 2 was lower in SS compared to TBI (p < 0.03). All 3 days PCT and CRP differed between TBI and SS (p < 0.005); PCT, but not CRP, differed between TBI and S on day 2; in contrast, only PCR differed between S and SS on days 2 and 3 (p <0. 001).