Signs and Symptoms

Published on January 2017 | Categories: Documents | Downloads: 43 | Comments: 0 | Views: 269
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The clinical signs of neonatal sepsis are nonspecific and
are associated with characteristics of the causative
organism and the body's response to the invasion. These
nonspecific clinical signs of early sepsis syndrome are
also associated with other neonatal diseases, such
asrespiratory distress syndrome(RDS), metabolic
disorders,intracranial hemorrhage, and a traumatic
delivery. Given the nonspecific nature of these signs,
providing treatment for suspected neonatal sepsis while
excluding other disease processes is prudent.

Cardiac signs: In overwhelming sepsis, an initial early
phase characterized by pulmonary hypertension,
decreased cardiac output, and hypoxemia may
occur.These cardiopulmonary disturbances may be due
to the activity of granulocyte-derived biochemical
mediators, such as hydroxyl radicals and thromboxane
B2,an arachidonic acid metabolite. These biochemical
agents have vasoconstrictive actions that result in
pulmonary hypertension when released in pulmonary
tissue. A toxin derived from the polysaccharide capsule of
type III Streptococcus has also been shown to cause
pulmonary hypertension. The early phase of pulmonary
hypertension is followed by further progressive decreases
in cardiac output with bradycardia and systemic
hypotension. The infant manifests overt shock with pallor,
poor capillary perfusion, and edema. These late signs of
shock are indicative of severe compromise and are highly
associated with mortality.

Metabolic signs: Hypoglycemia, hyperglycemia, metabolic
acidosis, and jaundice all are metabolic signs that
commonly accompany neonatal sepsis syndrome.The
infant has an increased glucose requirement because of
sepsis. The infant may also have impaired nutrition from a
diminished energy intake. Metabolic acidosis is due to a
conversion to anaerobic metabolism with the production
of lactic acid. When infants are hypothermic or they are
not kept in a neutral thermal environment, efforts to
regulate body temperature can cause metabolic acidosis.
Jaundice occurs in response to decreased hepatic
glucuronidation caused by both hepatic dysfunction
and increased erythrocyte destruction.
Neurologic signs: Meningitis is the common manifestation of
infection of the CNS. It is primarily associated with GBS
(36%), E coli (31%), and Listeria species (510%)infections, although other organisms such as S
pneumoniae, S aureus, Staphylococcusepidermis, H
influenzae, and species of Pseudomonas,

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