Sepsis (peds)

Revisión del 23:13 13 jun 2011 de Jswartz (discusión | contribs.) (Created page with "==Background== *Neonatal Sepsis **Early onset ***First few days of life ***Fulminant, assoc w/ maternal or perinatal risk factors ***Septic shock and neutropenia are more common ...")
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Background

  • Neonatal Sepsis
    • Early onset
      • First few days of life
      • Fulminant, assoc w/ maternal or perinatal risk factors
      • Septic shock and neutropenia are more common
    • Late onset
      • Occurs after 1wk of age
      • Gradual
      • Meningitis more likely

Diagnosis

  • Temperature instability (temp >100.4)
  • CNS dysfunction
  • Respiratory distress
  • Feeding disturbance
  • Jaundice
  • Rash
  • Lethargy, irritability, sz
  • Apnea, tachypnea, grunting
  • Vomiting, poor PO, gastric distention, diarrhea

Work-Up

  1. CBC
  2. UA/Ucx
  3. CXR
  4. CSF
  5. Blood Cx

Treatment

  • Neonatal
    • Ampicillin 50mg/kg + gentamicin 2.5mg/kg + acyclovir
      • If gram-negative strongly suspected replace gent w/ cefotaxime or ceftaz
        • Have better CNS penetration

Disposition

  • Admit all neonates

Source

Tintinalli

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