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Sepsis Neonatorum
Infection of NB up to 1 month of age, caused by organisms that don't cause disease in older children.
Newborns lack IgM (protects against bact) b/c it doesn't cross pacenta.
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Testing of Neonate exposed to Infective Agent
- Blood culture - peripheral site - an and aerobic
- Spinal fluid if CNS s/s
- Urine culture (sterile/suprapubic)
- Skin cultures
- Trachael aspirate cultures
- CBC
- WBC w/diff (low 5000 = sepsis)
- Low neutroph/high band = infection
- Serum IgM elevated = infection
- CRP
- Xray chest
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Behaviors that Warrent Investigation in Neonate
- Subtle behavioral changes
- Temp instability
- Feeding intolerance
- Hyperbilirubinemia
- Tachycardia w/apnea/bradycardia
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Maternally Tx NB Infections
- Group B Strep
- Congenital Syphilis
- Gonorrhea
- Herpes Type 2
- Cytomegalovirus (CMV)
- Oral Candidal Infection (Thrus)
- Chlamydia Trachomatis
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Neonatal Sepsis ABX/AVR Therapy
- Acyclovir IV: Herpes
- Ampicillin IM/IV: listeria, ecoli, meningitis
- Cefotaxime IM/IV: NOT pseudomonas or listeria
- Gentamicin IM/IV: staph, e coli, pseudos (toxicity!!!)
- Vancomycin IV: MRSA
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Physiological Support to NB w/Septicemia
- Thermal, humidity, O2
- Resp support
- CV support
- Caloric support
- F/E support (homeostasis) (wt maint) (urine)
- Monitor: hypoglycemia/natremia/calcemia (or hyper), acidosis
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