Neonatal Sepsis

Question 1

When is sepsis most commonly seen in foals?

Answer 1

in the neonatal period –> <10-14 days old

Question 2

What are 5 predisposing factors for foals to develop neonatal sepsis?

Answer 2

1. failure of passive transfer
2. placentitis
3. adverse events at time of birth
4. endemic pathogens at breeding or foaling facilities
5. maternal illness

Question 3

What are the 4 most common routes of introduction of pathogenic bacteria that cause sepsis in foals?

Answer 3

1. inhalation
2. ingestion
3. wounds
4. umbilicus

Question 4

What is considered an adequate concentration of IgG in foals?

Answer 4

> 800 mg/dL –> any less is considered incomplete/compete failure of passive transfer

Question 5

Two or more of what manifestations are present with sepsis?

Answer 5

• hyperthermia or hypothermia
• tachycardia
• tachypnea
• leukopenia or leukocytosis
• > 10% immature (band) neutrophils

Question 6

How does sepsis lead to systemic inflammatory response (SIRS)?

Answer 6

circulating bacteria and their products (endotoxins) cause the host’s immune response to produce numerous cytokines and mediators in efforts to combat the infection –> TNFa, IL-1, IL-6 produce a strong and exuberant inflammatory response that becomes uncontrolled, leading to systemic disease, shock, and death

Question 7

What is the most common bacterial isolate from neonatal sepsis in foals? What other isolates are common?

Answer 7

E. coli

• Klebsiella
• Enterobacter
• Enterococcus
• Staphylococcus
• Streptococcus

Question 8

What clinical signs are indicative of neonatal sepsis in foals?

Answer 8

• weakness, lethargy
• jaundice
• diarrhea
• hypothermia
• tachycardia, tachypnea
• hypovolemia
• petechia
• swollen joints
• leukopenia, neutropenia, left shift, toxic neutrophils
• hypoglycemia
• acidemia, high serum lactate

Question 9

What is the best diagnostic for neonatal sepsis in foals?

Answer 9

positive blood culture - allows for exact identification of bacteria and provides an antimicrobial susceptibility pattern for treatment

Question 10

What is most commonly included in the treatment of neonatal sepsis in foals?

Answer 10

• fluid therapy
• antimicrobials
• nutritional support
• plasma transfusions
• ventilator support
• diligent nursing and supportive care –> guarded to good prognosis!

Question 11

What are 6 common complications associated with neonatal sepsis in foals?

Answer 11

1. septic arthritis
2. thrombophlebitis
3. septic physitis
4. pneumonia
5. omphalophlebitis
6. diarrhea