Neonatal Sepsis

Why is this topic important?

Major cause of neonatal morbidity and mortality and commonly tested in MRCPCH.

Definition

Systemic infection occurring during the neonatal period.

Key MRCPCH Facts

• Early onset <72 hours

• Late onset >72 hours

• GBS is a common cause

• E. coli important in preterm infants

Risk Factors

• Maternal fever

• Prolonged rupture of membranes

• Chorioamnionitis

• Prematurity

Clinical Features

• Temperature instability

• Apnoea

• Respiratory distress

• Poor feeding

• Lethargy

Investigations

• Blood culture

• FBC

• CRP

• Lumbar puncture when indicated

Management

• Prompt antibiotics

• Supportive care

• Escalation if unstable

Common Exam Traps

Sepsis may present without fever.

One Minute Revision

Think sepsis in any unwell newborn.

Related QOTD

Most common cause of early-onset sepsis?

Answer: Group B Streptococcus.

References

1. NICE Neonatal Infection Guideline

2. RCPCH Guidance

3. BNF for Children

4. Nelson Textbook of Pediatrics

Disclaimer

For educational and MRCPCH revision purposes only.