Neonatal sepsis
| one of the causes of the collapsed neonate | |
|---|---|
| Etiology | Pathogens: Group B Strep (Strep agalactiae), E. coli. Onset: within 24h (“early”)/after 7d (“late”). Early: resp; late: meningitis. |
| Epidemiology | Risk factors: prematurity, prolonged birth, foetal distress, Group B strep RF, maternal infection; late: prematurity |
| Clinical presentation | non-specific, non-localising signs - resp distress (e.g. grunting), seizures, apnoeas, full fontanelle, hypothermia, hypoglycaemia |
| Diagnostic investigations | Septic screen, i.e. blood cultures, urine cultures, +/- CSF |
| Management | Resuscitation as per APLS Empirical cefotaxime + amox ± gent ± metronidazole Prevention: ➥ If maternal GBS colonisation or pyrexial, maternal IV benpen during labour ➥ observe 24h ➥ offer swabs at 35-38 weeks |