Pneumonia Flashcards
What is the definition of pneumonia in neonates?
Infection of the fetal or newborn lung
May be intrauterine or neonatal
What are the two types of pneumonia based on when the infection occurs?
Intrauterine and Neonatal
Intrauterine occurs before birth, while Neonatal is acquired after birth
What are common causes of intrauterine pneumonia?
Ascending passage of infecting agent, Transplacental transmission, Aspiration of meconium or infected amniotic fluid during delivery
Intrauterine infections can occur due to maternal conditions or procedures
What is the incidence of neonatal pneumonia?
Varies from center to center and according to causative agent
It is the most common neonatal infection, accounting for significant morbidity and mortality
What is the risk factor for infection in preterm infants?
Greatest risk due to immature immune system and lack of protective maternal antibodies
1% of term infants, 10% of preterm infants are affected
List some common pathogens that cause neonatal pneumonia.
- Group B strep
- E. Coli
- Staphylococcus Aureus
- Klebsiella
- H. Influenza type B
- CMV
- Herpes
- Enteroviruses
- Chlamydia
- Tuberculosis
Pathogens vary based on the infant’s condition and history
What is a potential outcome for infants with congenital pneumonia?
Infant may be born critically ill or stillborn
Evidence of pulmonary inflammation is found in a significant percentage of stillborn infants
What factors can contribute to the development of congenital pneumonia?
- Maternal chorioamnionitis
- Prolonged rupture of membranes
- Excessive obstetric manipulation
- Prolonged labor with intact membranes
- Maternal urinary tract infections
These factors can lead to infection and complications during birth
What are common clinical presentations of neonatal pneumonia?
- Tachypnea
- Grunting
- Retractions
- Cyanosis
- Hypoxemia
- Hypercapnia
- Severe shock-like syndrome
Symptoms may be indistinguishable from other respiratory distress forms
What physical examination signs may indicate pneumonia?
- Diminished breath sounds
- Localized dullness
- Harshness or rales
These signs can vary and may mimic other conditions
What are the differential diagnoses for neonatal pneumonia?
- RDS
- Sepsis
- TTN
- Meconium aspiration
- Lung hypoplasia
- Pulmonary hemorrhage
- Congenital heart disease
Each of these conditions can present similarly to pneumonia
What are some complications associated with neonatal pneumonia?
- Respiratory failure
- Meningitis
- Cardiopulmonary complications
- Septic shock
- DIC
- PPHN
Complications can significantly impact the infant’s health
What is included in the management of neonatal pneumonia?
- Antibiotic therapy
- Supportive care
- Monitor blood pressure
- Maintain oxygenation and ventilation
- Correct metabolic acidosis
Management aims to stabilize the infant and treat the infection
What additional treatments may be used if conventional treatment fails?
- Exchange transfusion
- Granulocyte transfusion
- IVIG
- High frequency ventilation
- ECMO
These treatments are advanced and used in critical cases
