Neonatal Sepsis

Posted by e-Medical PPT
Neonatal sepsis specifically refers to the presence of a serious bacterial infection(such as meningitis, pneumonia, pyelonephritis, or gastroenteritis) in the setting of fever. Criteria with regards to hemodynamic compromise or respiratory failure are not useful clinically because these symptoms often do not arise in neonates until death is imminent and unpreventable.It is difficult to clinically exclude sepsis in newborns less than 90 days old that have fever.Except in the case of obvious acute viral bronchiolitis, the current practice in newborns less than 30 days old is to perform a complete workup including complete blood count with differential, blood culture, urinalysis, urine culture, and cerebrospinal fluid(CSF) studies and CSF culture, admit the newborn to the hospital, and treat empirically for serious bacterial infection for at least 48 hours until cultures are demonstrated to show no growth.Attempts have been made to see whether it is possible to risk stratify newborns in order to decide if a newborn can be safely monitored at home without treatment despite having a fever. One such attempt is the Rochester criteria.

Neonatal sepsis screening:
1. DLC showing increased numbers of polymorphs.
2. DLC: band cells > 20%.
3. increased haptoglobins.
4. micro ESR (Erythrocyte Sedimentation Rate) titer > 55mm.
5. gastric aspirate showing > 5 polymorphs per high power field.
6. newborn CSF (CerebroSpinal Fluid) screen: showing increased cells and proteins.
7. suggestive history of chorioamnionitis, PROM (Premature Rupture Of Membranes)

Share Medical Presentations