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Neonatal Sepsis:<sup>Q</sup>

  1. M/C cause of neonatal mortality (50%)
  2. Early onset (onset before 72 hrs)
  3. Late onset (onset after 72 hrs)

Predisposing Factors: Q

 

EARLY LATE : M/C cause is hands of caregivers Q
1. LBW 1. LBW
2. PROM 2. lack of breast feeding
3. Foul smelling liquor 3. pyoderma
4. Maternal fever 4. umbilical sepsis
5. Prolonged and difficult labor 5. aspiration of feeds
6. Aspiration of meconium 6. needle pricks
  7. IV fluids

 

Etiological Factors:

 

M/C/cause of newborn septicamia

 

India –

  1. Klebsiella – 1st West – S. Agalatic
  2. Steph – 2nd

Clinical Features: Q

  1. Alteration in feeding behavior
  2. Hypothermia
  3. Diarr/ vom/ abdominal distension/ Lethargy
  4. Apneic spells
  5. Poor perfusion

Presumed Early Sepsis:

 

If any 3/8 Parameters are presents.

  1. Pre term < 37 wks
  2. Foul smelling liquor
  3. Maternal fever - 24 hrs of >38°C within 2 weeks of delivery
  4. PROM > 18 hrs
  5. > 3 vaginal exam during labor
  6. Birth asphyxia Apgar <3 at 5 min
  7. Prolonged or difficult delivery with instrumentation
  8. Polymorphs in gastric aspirate

Investigations

  1. Septic screen:
    1. TLC <5000 / >20000 /mm3
    2. ANC <1800 /mm3
    3. I/T ratio >0.2
    4. CRP > 1mg/dl
    5. Micro ESR 15 mm or more
  2. Haptoglobin -
  3. Gram staining Of Gastric aspirate' > 5 polymorphs
  4. CSF
  5. CxR
  6. Blood C/S
  7. Urine C/S

TREATMENT:

  1. Antibiotics
  2. Supportive

Duration of Treatment

  1. Pneumonia /septicemia - 7-10 days Q
  2. Meningitis - 3 wks Q
  3. Septic arthritis - 4-6 wks
  4. Ventriculitis - 6-8 wks




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