sepsis zohra and faiza.pptx pediatrics lectures

Sepsis in newborns, or neonatal sepsis, is a serious medical condition that occurs when a baby younger than 28 days old has a life-threatening response to an infection. Bacterial infections are the most common cause of neonatal sepsis. If your newborn has sepsis, it's a medical emergency.

1. PEDIATRICS PRESENTATION Faiza liaqat Zohra nazir

2. CASE A full term one week old infant presents with fever, poor feeding, and a bulging fontanel. Mother has history of prolonged rupture of membranes and a low-grade fever. Spinal fluid of infant demonstrates Gram-positive cocci. Cerebrospinal fluid -is turbid with 5500 WBC/mm³ and a low glucose.

3. NEONATAL SEPSIS

4. DEFINITION

5. types

6. Incidence

7. Predisposing factors HOST FACTORS Impaired cellular response Impaired humoral response Serum complement levels are low Lack of secretory IgA

8. MATERNAL FACTORS Poor socioeconomic status Maternal illness at the time of delivery Intra-partum maternal fever Prolonged rupture of membranes/ prolonged labor Maternal amnionitis Multiple gestations Maternal genital tract infections

9. ENVIRONMENTAL FACTORS Home delivery Low birth weight Birth asphyxia Bacterial contamination at the time of labor and delivery Unclean hospital and nursery environment and Prematurity

10. ETIOLOGY Congenital Infections. E.g., TORCH E.coli Group B Streptococcus Klebsiella Pseudomonas Staphylococcus Proteus

11. Clinical Findings GENERAL NEUROLOGIC RESPIRATORY CARDIAC GASTROINTESTINAL RENAL HEMATOLOGIC OTHERS Fever/hypothermia Irritability Apnea Pallor, mottling Abdominal distension Oliguria Jaundice Omphalitis Refusal to feed Seizures Tachypnea Cold skin Vomiting Splenomegaly Cellulitis Edema Hypotonia, inactivity Retractions Tachycardia Diarrhea Pallor Body colour changes Abnormal moro reflex Flaring, grunting Hypotension Hepatomegaly Petechiae, purpura Full/bulging fontanel cyanosis Bradycardia bleeding

12. INVESTIGATIONS Adjunctive tests white cell count (>30,000/mm³) or (<4,000/mm²) is significant Immature neutrophils (>25%) or band-neutrophil ratio of 0.2 or higher. Low platelet count (less than 150,000/mm³) High ESR C-reactive protein or Procalcitonin. Chest X-ray, . SPECFIC DIAGNOSIS Blood culture Cerebrospinal fluid Urine culture Tracheal aspirates

13. Management It is advisable to get a culture report before starting antibiotic treatment. But, antibiotic therapy should not be delayed if the infant is in serious condition

14. EARLY ONSET SEPSIS

15. Late Onset Sepsis

16. SUPPORTIVE TREATEMENT

17. COMPLICATIONS

18. Prevention Maternal vaccination against preventable diseases [Rubella, VZV, Hep-B, Tetanus] Breast feeding and hand washing are helpful in preventing late onset sepsis Cord care Clean and safe delivery Aggressive management of suspected chorioamnionitis with antibiotic therapy Aseptic baby environment