新生儿学（Neonatology）.pptVIP

Nonspecific signs and symptoms Responses decrease: 1. Feeding 2. Crying 3. Movement 4. Temperature 5. Body weight 6. Reaction Atypical manifestations  in the early stage Clinical Manifestations continued Clinical Manifestations continued Systematic damages Aggravate/increase 1. Pathological jaundice: bilirubinemia 2. bleeding 3. hepatosplenomegaly 4. Respiratory: Tachypnea, apnea,cyanosis 5. Gastrointestinal: vomiting or diarrhea 6. CNS: lethargy, seizure Clinical Manifestations continued Clinical Manifestations continued Complications: 1. Meningitis 2. Pneumonia 3. Liver abscess 4. Peritonitis 5. Osteomyelitis Diagnosis 1. Early recognition of the symptoms and signs of neonatal septicemia is important in diagnosis. 2. History and physical examination, coupled with clinical experience, are the best guides in determining the diagnosis. 3. If doubt exists, a blood culture and secretions cultures should be obtained Diagnosis continued Laboratory tests: (nonspecific tests) 1.WBC: 5,000 / mm3 25,000/ mm3 2.C-reaction protein(CRP): ↑ in acute stage Bacterial septicemia strongly suggested Diagnosis continued Laboratory tests (Specific): Cultures: blood, CSF, and urine. A. Positive cultures: Confirmed diagnosis B. Negative cultures: can not rule out the infection. Diagnosis continued Differential diagnosis: 1.Respiratory:Tachypnea, apnea, cyanosis 2.Gastrointestinal:vomiting or diarrhea, 3.Pathological jaundice: hyperbilirubinemia Septicemia must be included in the differential diagnosis. Treatment The essentials of treatment: 1. antibiotic treatment 2. supportive therapy Treatment continued ● Antibiotic therapy: a. initiation early. b. toward suspected bacteria (combination) c. High dosage (enough) d. Enough therapeutic duration e. injection through vein Treatment continued Co