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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five infants with pneumococcal sepsis presented with respiratory distress and clinical signs of infection in the first day of life. Although there was no apparent epidemiological relationship among the patients, four of the five were seen within a 12-month period. Pneumonia, prolonged rupture of fetal membranes, and prematurity were features in these patients. Three infants died, two within 12 hours of diagnosis. Streptococcus pneumoniae was isolated from the vagina of three of the mothers; in two, the serotype was identical to that recovered from their infants. Clinical features of neonatal pneumococcal sepsis are similar to those of early-onset group B streptococcal infection. Like the group B Streptococcus, S. pneumoniae acquired from the maternal vagina is a potential life-threatening pathogen in the newborn period.
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PMID:Early-onset pneumococcal sepsis in newborn infants. 1 25

Chest radiographs of thirteen neonates with group B streptococcal septicemia were evaluated for signs of early diagnosis. Six of the neonates had chest radiographs as seen in idiopathic respiratory distress syndrome (RDS). Seven patients had radiologic findings consistent with neonatal pneumonia. The children with RDS were in general smaller and born prematurelly, but three neonates with x-rays resembling RDS had normal birth weights and thus were mature. Cardiomegaly was observed in a high percentage with a prevalence in children with RDS. Heart size increased in two of the three children who died, but became normal in patients recovering from infection. Three patients had pleural effusions.
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PMID:[Radiologic findings in newborns with group B streptococcal septicemia: clinical importance of heart size and lung manifestations (author's transl)]. 15 11

In a retrospective analysis of infants born with meconium staining over an 18-month period at Cook County Hospital, 32 infants met two of the three criteria for the diagnosis of meconium aspiration syndrome: (1) history of meconium in the oropharynx or trachea; (2) clinical evidence of respiratory distress; and (3) x-ray evidence of aspiration pneumonia. Seventeen infants developed respiratory failure; nine of these infants died. One infant without respiratory failure died of sepsis. Analysis of sequential arterial blood pH and gas tension showed that nonsurviving infants had persistently high PCO2 and A-a gradient in spite of initiation of assisted ventilation. These changes seem to be related to severe right-to-left shunting and ventilation perfusion abnormalities. The data further suggest that asphyxia and acidosis occur well before the infant is born and that intrapartum monitoring to recognize fetal asphyxia may help in improving morbidity and mortality from meconium aspiration syndrome.
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PMID:Assisted ventilation in infants with meconium aspiration syndrome. 24 Jan 48

This study describes the results of examination of blood cultures from infants born in a community with a high prevalence of fatal amniotic fluid infection. The incidence of first-week neonatal septicaemia was 5.5 per 1000 births. Septicaemia was detected in 38% within 12 hours and 75.6% within 72 hours of birth. The aetiological pattern of the septicaemia was similar to that of fatal amniotic fluid infections. The increase in mortality from septicaemia occurred in infants born after 34 weeks of gestation. Nearly 80% of the infections apparently occurred through intact membranes. Respiratory distress with or without radiological evidence of pneumonia was the only manifestation of septicaemia in most infants under four days of age. Low Apgar scores and multiple apnoeic episodes were more common in infants with septicaemia than in those without septicaemia. Neonatal jaundice with serum bilirubin in excess of 11 mg/dl was more common in septicaemic infants and indicated poor prognosis. Meningitis associated with septicaemia occurred in 3.8% and in all these infants the diagnosis of septicaemia was delayed beyond 72 hours. The results suggest that early recognition and treatment of antenatal bacterial infections may prevent mortality and morbidity from complications of septicaemia such as neonatal apnoea, meningitis and bilirubin encephalopathy.
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PMID:Consequences of amniotic fluid infections: early neonatal septicaemia. 26 66

Chest roentgenograms obtained in the first two days of life from 67 infants with respiratory distress were reviewed to determine whether the radiographic features of group B streptococcal septicemia were diagnostic or distinctive. The retrospective review contained 24 infants with proven and 14 with suspected septicemia, as well as 29 patients with other causes of respiratory distress. The films were reviewed in random order by two pediatric radiologists without their prior knowledge of clinical or laboratory data. Typical radiographic appearance of pneumonia was present in only ten of the 24 proven and two of the 14 suspected cases of group B streptococcal sepsis. The radiographic pattern of respiratory distress syndrome (RDS) was just as common among these patients. The most prominent associated radiographic feature of infants with proven septicemia was cardiomegaly which was significantly increased when compared with infants who had other causes of respiratory distress (P less than .001). X-ray recognition of neonatal group B streptococcal septicemia is limited because of superimposition of roentgen patterns probably related to associated disorders. Pediatrics, 59:1006-1011, 1977, NEWBRON, SEPTICEMIA, GROUP B STREPTOCOCCUS.
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PMID:Radiographic findings in early onset neonatal group b streptococcal septicemia. 32 89

Newborn infants with "early-onset" disease due to group B beta hemolytic streptococcus were studied over a 40-month period. Clinical presentations included asymptomatic bacteremia, mild transient illness, respiratory distress, meningitis, and overwhelming sepsis. Chronologically, 18 were ill at birth; 10 became ill after a symptom-free period; and four were asymptomatic. Sixty-six percent of the cases weighted less than 2500 grams, and 56% were born to mothers whose amniotic membranes were ruptured for over 20 hours. All 15 of the deaths occurred in low birth weight infants who were criticially ill from birth. A review of 128 consecutive deliveries of infants weighing under 2000 grams revealed 28 cases with prolonged ruptured membranes, and three of these 28 infants developed group B streptococcal infection. The infant of the colonized gravid woman in premature labor or with prolonged ruptured membranes is clearly at risk, and these results suggest that the management of "early-onset" disease should begin prior to delivery.
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PMID:Risk factors in early-onset neonatal group b streptococcal infections. 34 7

The newborn infant, particularly when premature, has a haemostatic mechanism which may not be entirely capable of withstanding the onslaughts of trauma, infection, asphyxia or other complications of the neonatal period. He is at risk of local or diffuse haemorrhage, which may at times be serious or even life-threatening. The cause of haemorrhage during the newborn period can generally be ascertained by a careful history and brief physical examination directed toward recognition of any predisposing factors or underlying diseases. Screening laboratory tests can usually be correctly interpreted as long as certain laboratory artifacts and physiological peculiarities of the neonatal coagulation mechanism are kept in mind. Diagnosis of and therapy for vitamin K deficiency and haemophilia in the healthy-appearing neonate is generally carried out with little difficulty. The seriously ill neonate with bacterial sepsis, respiratory distress syndrome, or extreme immaturity presents greater problems, for laboratory tests may be more difficult to obtain and interpret and underlying conditions may be untreatable. DIC occurs commonly in such neonates, and transfusion therapy, with or without heparin, is often unsuccessful. A persistent dilemma are those neonates with fatal intravascular haemorrhage, in whom definable haemostatic abnormalities are few and transfusion therapy is futile.
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PMID:Neonatal coagulation: normal physiology and pathophysiology. 35 Apr 67

Nowadays, in severe infections during the neonatal period new bacteria--group B streptococci--have to be taken into account, since in some clinics they already predominate over gramnegative rods. Septicemia and meningitis may be caused by group B streptococci. The septicemia which especially threatents prematures starts with apnoeic spells in the very first hours after birth and may be easily misdiagnosed as an idiopathic respiratory distress syndrome. The mortality is very high (about 60%). Meningitis starts later, normally during the 3rd to 4th week. Seizures are typical at the onset. Group B streptococci may be identified in the CSF by counterimmunoelectrophoresis within one hour. The prognosis is more favourable in meningitis than in septicemia (mortality about 20%). Survivors have little neurological sequelae. Penicillin G or ampicillin combination with an aminoglycoside is recommended as chemotherapy. Exchange transfusion should be considered early. Group B streptococci causing the septic form may be transfered during labour since up to 25% of pregnant women are colonized. Nosocomial transmission of group B streptococci may be the reason for meningitis. Prophylactic penicillin does not seem to help in preventing the disease, but it is possible, that meningitis of the newborn may be prevented by immunizing the mother during pregnancy.
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PMID:[Group B streptococcus infections during the neonatal period (author's transl)]. 35 54

The clinical features of 27 patients with early onset group B beta hemolytic streptococcus sepsis were reviewed. Fifteen presented with a clinical pattern indistinguishable from the idiopathic respiratory distress syndrome and were compared with 15 patients with IRDS. Rupture of membranes for greater than 12 hours prior to delivery occurred more often in patients with GBS (33%) than in the patients with IRDS (16%). Hypotension was more commonly seen in the patients with GBS (56%) than in the patients with IRDS (36%). There was no difference in the incidence of apnea or the respirator peak inspiratory pressure requirements between the two groups of patients, but there was a tendency for a decline in the total white blood cell count in the first 24 hours of life in those patients with GBS sepsis.
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PMID:Group B beta hemolytic streptococcal sepsis and the idiopathic respiratory distress syndrome: a comparison. 37 Mar 55

Immunofluorescence was performed on lung tissue obtained at necropsy from 18 newborn infants, including five with group B streptococcal (GBS) sepsis, seven with idiopathic respiratory distress syndrome (IRDS), and six control infants who died from other causes. Deposits of C3, IgG, and fibrin were found within hyaline membranes of infants who died with GBS sepsis or IRDS within 48 hours after birth. In some cases C4, factor B, and IgM were also observed. In five infants with IRDS who died more than five days after birth, immunofluorescent lung findings were less common and less intense. Hyaline membranes, attributed to mechanical ventilators and oxygen therapy in two infants who did not have GBS infection or IRDS, were negative for complement and immunoglobulins although fibrin was detected in one specimen. These data suggest that immunologic processes may contribute to the pathogenesis of certain types of acute lung injury, particularly in infants who die from GBS infection or IRDS during the early neonatal period.
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PMID:Immunofluorescence in group B streptococcal infection and idiopathic respiratory distress syndrome. 37 79


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