Neonatal Infections Flashcards
What is a congenital infection?
An infection that a neonate is born with. It is vertically transmitted from the mother.
What infections are screened for in pregnancy?
- Hepatitis B
- HIV
- Rubella
- Syphilis
What is the most common cause of congenital deafness?
Cytomegalovirus
What are the common causative agents of congenital infections?
TORCH: T - Toxoplasmosis O - Other (Syphilis, HIV, HBV) R - Rubella C - Cytomegalovirus H - HSV
What are the common presenting symptoms of congenital infections?
TORCH: T - Thrombocytopaenia O - Other (eyes: cataracts, glaucoma) R - Rash C - Cerebral abnormality H - Hepatosplenomegaly
What are the clinical features of congenital infections?
- No maternal sickness
- A wide range of severity in the child
What investigations are performed in congenital infections?
Serology screening
How do most carriers of toxoplasmosis present? How else can they present?
Most (60%) are asymptomatic. There is a long term sequelae involving deafness, a low IQ and microcephaly
Others who are symptomatic can experience seizures, and intracerebral calcification
How does rubella harm the host?
It causes mitotic arrest of cells
What are the clinical features of a congenital infection with rubella?
- Ophthalmic features: cataracts, glaucoma, microphthalma
- Cardiovascular syndromes
- Deafness
- Microcephaly
- Bone disease
- Hepatosplenomegaly
What are the clinical features of a congenital infection with HSV?
- A very ill child
- A wide spread, blistering rash
- Liver dysfunction
What is the neonatal period?
A period of 4-6 weeks after the child’s birth. If the child is premature, the neonatal period is adjusted according to the expected date of delivery
Why do neonatal infections occur more commonly in premature babies?
- There is reduced defence by maternal IgG
What is defined as an early neonatal infection?
An infection beginning within 48-72 hours of birth
What is defined as a late neonatal infection?
An infection beginning after 48-72 hours from birth
What are the most common causative organisms of early neonatal infections?
- Group B Streptococcus
- E. coli
- Listeria
What are the features of an early neonatal infection?
- Fever
- Possible meningism
What are the maternal risk factors for early neonatal infection?
- Premature rupture of membranes
- Fever
- Prolonged labour
- Previous history
- Meconium staining
What are the foetal risk factors for early neonatal infection?
- Prolonged labour
- Hypoglycaemia
- Low blood pressure at birth
What are the investigations for early neonatal infection?
Septic Screen:
- FBC
- CRP
- Blood culture
- Deep ear swab
- CSF with LP (especially if blood culture is positive)
- Chest X-Ray
How is a case of early neonatal infection managed?
Begin with an ABC approach, and give supportive fluids, and nutrition.
Benzylpenicillin (for GBS) and gentamicin (for E. coli). Antibiotics are used for 7-14 days, unless evidence of meningitis, in which case up to a 6 week course is initiated.
If the infection is caused by listeria, amoxacillin or ampicillin would be used.
What is group B streptococcus
A gram positive coccus, which is haemolytic
What can group B streptococcus cause in neonates?
- Bacteraemia
- Meningitis
- Disseminated infection
What is E. coli?
A gram negative rod. It is specifically the K1 antigen which causes the pathology in neonates
