Bacterial Sepsis and Meningitis

Nizet, Victor; Klein, Jerome O.

doi:10.1016/b978-1-4160-6400-8.00006-7

Cited by 68 publications

(70 citation statements)

References 696 publications

(588 reference statements)

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“…Bacteremia without an identifiable focus of infection is generally treated for 10 days. 87 Uncomplicated meningitis attributable to GBS is treated for a minimum of 14 days. 88 Other focal infections secondary to GBS (eg, cerebritis, osteomyelitis, endocarditis) are treated for longer durations.…”

Section: Treatment Of Infants With Suspected Early-onset Sepsismentioning

confidence: 99%

Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis

Polin¹,

Newborn²

2012

Pediatrics

661

433

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With improved obstetrical management and evidence-based use of intrapartum antimicrobial therapy, early-onset neonatal sepsis is becoming less frequent. However, early-onset sepsis remains one of the most common causes of neonatal morbidity and mortality in the preterm population. The identification of neonates at risk for early-onset sepsis is frequently based on a constellation of perinatal risk factors that are neither sensitive nor specific. Furthermore, diagnostic tests for neonatal sepsis have a poor positive predictive accuracy. As a result, clinicians often treat well-appearing infants for extended periods of time, even when bacterial cultures are negative. The optimal treatment of infants with suspected early-onset sepsis is broad-spectrum antimicrobial agents (ampicillin and an aminoglycoside). Once a pathogen is identified, antimicrobial therapy should be narrowed (unless synergism is needed). Recent data suggest an association between prolonged empirical treatment of preterm infants (≥5 days) with broad-spectrum antibiotics and higher risks of late onset sepsis, necrotizing enterocolitis, and mortality. To reduce these risks, antimicrobial therapy should be discontinued at 48 hours in clinical situations in which the probability of sepsis is low. The purpose of this clinical report is to provide a practical and, when possible, evidence-based approach to the management of infants with suspected or proven early-onset sepsis. Pediatrics

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Section: Treatment Of Infants With Suspected Early-onset Sepsismentioning

confidence: 99%

Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis

Polin¹,

Newborn²

2012

Pediatrics

661

433

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“…: malaria y toxoplasmosis) y fúngicas (ej. : candidiasis) 34 . Sin embargo, muchas de estas enfermedades tienen presentaciones clínicas típi-cas que nuestro paciente no presentaba.…”

Section: Discussionunclassified

Dengue perinatal: Reporte de caso

Manzano-Núñez

Zapata

García‐Perdomo

et al. 2017

Rev. chil. pediatr.

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Palabras clave:Dengue, virus dengue, Trasmisión vertical Antígeno NonStructural Protein I ResumenIntroducción: El dengue perinatal es una patología de la que poco se sabe, los reportes disponibles describen riesgo de resultados perinatales adversos. Objetivo: Reportar un caso de dengue perinatal, como diagnóstico diferencial de sepsis neonatal, que debe tenerse en cuenta en zonas endémicas. Caso clínico: Recién nacido de una mujer de 23 años quien a las 36 semanas de gestación presentó cuadro de dengue con antígeno Non-Structural Protein 1 (NS1) positivo y anticuerpos anti-dengue negativos. Al sexto día de enfermedad dio a luz a un recién nacido sano, quien, al segundo día de vida, presentó fiebre sin otros hallazgos patológicos al examen físico, asociado a trombocitopenia severa (17.900 plaquetas/uL) y aumento de la proteína C reactiva, antígeno viral NS1 positivo e inmunoglobulina G (IgG) anti dengue positiva. Fue manejado con antibióticoterpia con ampicilina y gentamicina por protocolo de la institución para sepsis neonatal probable. El neonato mostró mejoría clínica, con estabilidad hemodinámica y aumento significativo de plaquetas, siendo dado de alta. Conclusiones: El dengue en el embarazo trae consigo el riesgo de resultados perinatales adversos, particularmente bajo peso al nacer y parto pre-término. Los hijos de madres diagnosticadas con dengue al final del embarazo deberían ser observados estrechamente con realización de hemograma seriado en los primeros días de vida, debido al riesgo de transmisión vertical. Keywords:Dengue; Dengue virus; Vertical transmission Non-Structural Protein I Antigen Abstract Introduction: Few reports are available about perinatal dengue, with controversial results in regards the risk of perinatal outcome. Objective: To report a case of perinatal dengue as a differential diagnosis with neonatal sepsis, which must be considered in endemic areas. Clinical case: Male newborn of a 23 year-old female, who presented a Non-Structural Protein 1 (NS1) antigen positive to dengue at 36 weeks of gestation and negative anti-dengue antibodies. At day six of the illness a healthy newborn

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“…Ample number of erythrocytes in CSF may be interpreted as a clue to herpes simplex virus meningitis if the physician is sure that the LP was not traumatic. Pleocytosis is more marked in bacterial and Gram-negative meningitides than in viral and Gram-positive meningitides [6].…”

Section: Interpretation Of Csf Findingsmentioning

confidence: 94%

“…Although signs of sepsis and meningitis intertwine in the newborn period, some neonatologist deem it unnecessary to perform LP on neonates evaluated for sepsis, especially those with early neonatal sepsis [4,5], because the antibiotics for both conditions would be the same. However, it should be kept in mind that blood cultures are negative in one-third of neonates with meningitis who are very-low-birth-weight and born over 34 weeks of gestation [6]. Thus, in case of LP is not performed, a significant portion of neonates with meningitis would not get a correct diagnosis and would not be observed for the likely complications of meningitis.…”

Section: Indicationsmentioning

confidence: 99%

Lumbar Puncture of the Newborn

Öncel¹

2018

Bedside Procedures

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Bacterial Sepsis and Meningitis

Cited by 68 publications

References 696 publications

Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis

Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis

Dengue perinatal: Reporte de caso

Lumbar Puncture of the Newborn

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