Neonatal Sepsis Flashcards
Neonatal sepsis presents how
Anything
GEN-lethargy ,irritable ,temp instability
RS-distress
CVS-bradycardia
GIT-poor feeding,vomiting,and distention ,jaundice
CNS-seizure ,tense fontanell,opisthotonos
Neonatal sepsis catogories
Early onset before 72 h
Late onset after 72h -3 months
Early onset sepsis risk factors4
PROM
Chorioamnionitis
Maternal fever-UTI
Preterm
Organisms come from where in early onset
Fecal o vaginal origin>membranes>amniotic fld>res tract of fetus>sepsis>meningitis
Ix in neonatal sepsis 5
FBC Blood cultures CRP Xray If meningitis suspect CSF
CRP rices when and how does it help
In diagnosis
Rises 12-24 hours later
One value normal can’t exclude sepsis
It 2normal sepsis unlikely
Organisms in early sepsis
Gram pos- group B streptococci
Listeria monocytogen
Gram neg-ecoli and others
Treatment in early sepsis given when what
When to stop
When to check CSF
Broad spectrum AB wo waiting for reports Genta and c pen
If cultures neg CRP normal omit in 48hrs
If culture positive O any CNS signs
Late onset sepsis sources 2
Usually from environment
Also
From birth canal
Organisms in late sepsis 5
Common -Staph epididimis
Staph aureus
Pseudomonas
Candida
Less common-group B strepto
Listeriap
Treatment in late sepsis
Initially to cover what if not responding
Staph and gram negatives -flucloxacc and Genta
Not resp-Vancomycin
If meningitis suspected antibiotics
Penicillin and 3rd gen cephalosporin;cefotaxim)
Complications of meningitis early and late
Early -ventriculitis,abscess,hydrocephalus
Late-SN deafness ,cp
Grp B streptocc sources 2
Vaginal
Feacal
How is GBS transmitted to baby
At delivery
Ascending infection
When will GBS sympt present 2
Early
Late 3days to 3 weeks
GBS early and late presents how
Pneumonia
Sepsis
Meningitis -rare
Late meningitis
osteomyelitis
Septic arthritis
How can it be prevented
By selective and universal screening of mothers and antibiotic prophylaxis at delivery if positive
How is Listeria infection transmitted to mother
By consumption of food (unpasteurized milk,under cooked poultry )
Mothers present how2
Flu like illness
Asymptotic fecal or vaginal carriers
How the listeria transmitted to baby3
Transplacentally
Ascending
Vag.canal
Complication of transplacenta infection 3
Abortion
Preterm delivery
Fetal infection
Characteristic symptom
In listeria infection
Preterm with Meconium
Listeria early 4 and late infection types
Pneumonia
Sepsis
Rash
Meningitis
Late-meningitis
Ecoli and gram neg source
Fecal and vaginal
Sticky eye in neonates when
And tx
3-4 day
Clean with NS O water
Eye discharge only organisms and treatment
Streptococci , staphylococci
Rx-topical Antibiotics
Eye swelling and discharge organisms 2
Gonnorrhea
Chalmedia trachimatis
Gonnococal infection present when
Ix
Rx
Complication
<48hrs
Gram stain and culture
Iv AB
Blindness
Chlamydia present when 2
Ix
Rx
Commonly in 1-2 weeks, some time at birth
Immunofluracent staining
Oral erythromycin 2 weeks
Umbilical infection rx
Um granuloma rx
Systemic AB
silver nitrate or copper sulphate
HSV Infection sources
Birth canal
Ascending
HSV infection risk high when in primary or recurrent
Primary
HSV present when
How4
Up to 4 weeks
Lesions in skin ,eye ,encephalitis, disseminated
Rx in HSV
Acyclovir
If mother has HSV lesion in genitalia delivery how
If recurrent infection deliver how
El lscs
Vaginally as transmission risk less after treating mother
Hep B which baby’s should receive vaccination and when
Who should be given immunoglobulin and when
Mothers HBs Ag pos
Shortly after birth
E Ag pos but no AB in mother
In first day
