Neonatal sepsis
From IDWiki
Background
Microbiology
Pathophysiology
- Thought to be generally acquired vertically during birth from the genitourinary tract
Clinical Manifestations
- May be just a fever
- Fussiness, lethargy, behavioural changes, decreased in frequency and volume of wet diapers, decreased feeding
- Tachypnea, tachycardia, fever, signs of dehydration, neurologic signs, increased work of breathing, jaundice
- WBC and CRP may be normal early in the course of illness despite severe bacterial infection
Management
- An axillary temperature higher than 37.5ºC (rectal greater than 38ºC) in an infant younger than 3 months older should be investigated
- The PECARN Step by Step approach can be used to identify patients at low risk, based on general appearance, age ≤21 days, leukocyturia, procalcitonin ≥0.5 ng/mL, and CRP > 20 mg/L or ANC > 10
