Topics Discussed: fever of the newborn; infectious diseases; neonatology; septicemia of newborn.
Sections: The Febrile- or Septic-Appearing Neonate: Introduction, Fever, Clinical Presentation, Specific Bacterial Etiologies, Specific Viral Etiologies, Evaluation, Treatment, Specific Conditions That May Present as or Like Neonatal Sepsis, References.
- The risk of serious bacterial infection (SBI) is greatest during the neonatal period, defined as birth to 28 days of life. Some authorities recommend that a child born prematurely should have the degree of immaturity subtracted from the child's chronological age for this consideration.
- It is generally accepted that a fever is a temperature of 38°C or 100.4°F taken with a rectal thermometer.
- A neonate who had a documented fever by any method but is afebrile on admission to the ED should be treated as a febrile neonate whether or not antipyretics have been given.
- The most frequent bacterial pathogens in the neonatal period are group B Streptococcus (GSB), Escherichia coli, and Listeria monocytogenes.
- Hypothermia is a rectal temperature less than 36°C or 96.8°F and, in the neonatal period, may actually be a more common presentation than elevated temperature. All neonates with hypothermia should be treated as septic.
- Causes other than SBI, especially herpes simplex virus (HSV) infection, should be considered and, if suspected, treated expectantly.
- Noninfectious problems, such as congenital heart disease (CHD) and inborn errors of metabolism, may present in a similar way and must always be on the list of potential causes of the septic-appearing infant.
- If the child is exhibiting..."
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