Neonatal Infection

Question 1

What are the complications of a congenital rubella infection?

Answer 1

1. Congenital heart disease
2. Sensorineural hearing loss
3. Congenital cataracts; glaucoma

Question 2

What are the complications of a congenital CMV infection (most common TORCH infection)?

Answer 2

1. IUGR

2. Thrombocytopenia; purpuric skin lesions

Question 3

What is the key complication of a congenital toxoplasmosis infection?

Answer 3

Chorioretinitis

Question 4

What are the two causes of ophthalmmica neonatorum and when is their onset?

Answer 4

1. Chlamydia - birth to 5 days postpartum

2. Gonorrhoea - 5 to 14 days postpartum

Question 5

What are the risk factors for neonatal infection/sepsis?

Answer 5

Prolonged rupture of membranes >18hrs, mother GBS+ve carrier, preterm labour, foetal distress, breaks in neonatal skin/mucosa, CVP/catheters, congenital malformations, immunodeficiency.

Question 6

What are the signs for neonatal sepsis (labile and non-specific)?

Answer 6

Labile temperature, lethargy, poor feeding, respiratory distress, collapse, DIC.

Question 7

What is the immediate management for neonatal sepsis?

Answer 7

1. ABCDE
2. Supportive - ventilate, volume expansion, inotropes
3. FBC, CRP, glucose, blood cultures
4. CXR, LP
5. If failure to respond in 24hrs, stool and throat virology for HSV, urine CMV culture, VDRL.

Question 8

What is the antibiotic therapy for neonatal sepsis?

Answer 8

1. Benzylpenicillin and gentamicin until culture results back.
2. Add cefotaxime if meningitis suspected.
3. Coagulase -ve Staph sepsis more likely in preterm infant with a CVP line - give vancomycin