Please enable JavaScript.
Coggle requires JavaScript to display documents.
Infectious Diseases in Neonates - Coggle Diagram
Infectious Diseases in Neonates
GBS
10-30% of pregnant women have faecal/vaginal carriage
1/2 of infants to these mothers will be colonised on their mucous membranes + skin
causes....
sepsis
early
a/w resp distress + pneumonia
may cause septicaemia + meningitis
late
up to 3mo old
meningitis or focal disease (osteomyelitis, septic arthritis)
pneumonia
meningitis
risk factors
PROM
prolonged ROM
maternal fever (>38) during labour
maternal chorioamnionitis
previously infected infants
give intrapartum prophylactic IV antibiotics to mothers with risk factors
Prevention strategies
universal 3rd tri screening in USA + Australia
in Ire + UK no screening, women with risk factors offered antibiotics
Listeria monocytogenes
Uncommon but serious
Maternal infection
From foods: upasteurised milk, soft cheese, undercooked poultry
mild ILI
placental passage to foetus
may cause spontaneous abortion, PTB
Can cause foetal/neonatal sepsis
mec stained liquor
widespread rash
septicaemia
pneumonia
meningitis
mortality = 30%
Late onset disease can occur
usually meningitis
better prognosis
Gram -ve infections
infected central venous lines
seeding to circulation from intestines
Conjunctivitis
Sticky eyes common in 3rd/4th day of life - just clean, not an infection
Staph/strep
discharge + redness
tx = topical antibiotic eye ointment (neomycin)
Gonorrhoea
purulent discharge in first 48hr of life
gram stain + culture
tx immediately as can cause permanent vision loss
risk of penicillin resistance so give 3GC IV
Chlamydia trachomatis
purulent discharge + swollen eyes @ 1-2 wks old
do immunofluorescent staining
tx = PO erythromycin x 2wks
check + tx mum + partner
Umbilical infection
surrounding skin becomes inflammed
HSV
neonatal infection uncommon
usually due to infected birth canal, occasionally ascending infection
high risk if primary infection in mother while pregnant
low risk in recurrent maternal infection
more common in premies
can present up to 4 wks old
clinical signs
herpetic lesions on skin/eyes
encephalitis
disseminated disease (high mortality)
Do elective C section if primary infection or genital lesions @ time of delivery
Hep B
if mother HBsAg +ve give baby vaccine shortly after birth
complete course during infancy + check Ab response
highest risk when mother e antigen +ve
give these babies passive immunisation with Ig within 24hr of birth