Do not miss sepsis in babies thatpresent with fever
Do not miss sepsis in babies thatpresent with fever: Excerpt from Avoiding Common Pediatric Errors
Author:
Cynthia Gibson, MD
What to Do - Interpret the Data
Evaluation and treatment of a neonate for possible bacterial infection and
sepsis is one of the most common pediatric practices. Signs and symptoms of
sepsis in a neonate are quite broad and include respiratory distress, lethargy
or irritability, fever or hypothermia, hypo-or hyperglycemia, acidosis, hypotonia, poor feeding apnea, cyanosis, seizures, poor perfusion, shock, unexplained jaundice, or simply "not looking well." Ten percent of full-term
babies with fever not due to environmental causes may have bacterial sepsis.
Because the neonate's response to sepsis is generic and often confusing, a systematic approach that does not vary is important for assuring that
all infants with potential sepsis are identified. Evaluation of a neonate with
fever should include a complete history and physical. Laboratory investigations include a complete blood cell count with a white blood cell differential,
blood culture, urine culture, and lumbar puncture. Other potentially useful
tests may include a chest x-ray, C-reactive protein, erythrocyte sedimentation rate, and a bacterial antigen profile. Although the large proportion
of septic workups in infants are negative, the method exists to assure that
thosebabieswithpotentiallydevastatingmeningitisareidentifiedandtreated
early. Treatment should begin as soon as possible and include antibiotics that
cover organisms commonly found in the neonatal period, including group
B streptococci and Escherichia coli.
Suggested Readings
Bergman DA, Mayer ML, Pantell RH, et al. Does clinical presentation explain practice vari
ability in the treatment of febrile infants? Pediatrics. 2006;117:787–795.
Gerdes JS. Diagnosis and management of bacterial infections in the neonate. Pediatr Clin North
Am. 2004;51:939–959.
Van den Bruel A, Bruyninckx R, Vermeire E, et al. Signs and symptoms in children with a
serious infection: a qualitative study. BMC Fam Pract. 2005;6:36.
Book Source Details
- Book Title: Avoiding Common Pediatric Errors
- Author(s): Anthony D Slonim MD, DrPH; Lisa Marcucci MD
- Year of Publication: 2008
- Copyright Details: Avoiding Common Pediatric Errors, Copyright © 2008 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Avoiding Common Pediatric Errors
Authors: Anthony D Slonim MD, DrPH; Lisa Marcucci MD
Publisher: Lippincott Williams & Wilkins
Copyright: 2008
ISBN: 0-7817-7489-6
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