Sepsis is a clinical syndrome in which an infection leads to an inflammatory response throughout the body that rapidly progresses to organ dysfunction or even death. Worldwide, neonatal sepsis affects 2,202 infants per 100,000 live births, and has a mortality rate of >11%. In the United States, early onset sepsis affects 50 in 100,000 live births, with a mortality rate of about 3%. So it’s a big problem that we don’t want to miss. In this episode, we will define neonatal sepsis, talk about the presentation of sepsis, what a sepsis workup entails, how to make the diagnosis and treatment of neonatal sepsis.

1. Defining Neonatal Sepsis 
   1. Early Onset Sepsis
   2. Late Onset Sepsis
2. Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/
3. Presentation of Illness and Physical Exam 
4. Pathogenesis
   1. Group B Strep
      1. Screening and prophylaxis 
   2. E coli
   3. Strep viridans
   4. Klebsiella
   5. Enterococcus
   6. Listeria 
   7. HSV 
      1. Screening and prophylaxis 
5. Types of Infection
   1. Bacteremia 
   2. Pneumonia
   3. Meningitis 
6. Work up 
   1. CBC with differential 
   2. Blood Culture
   3. Urinalysis and Urine Culture
   4. Cerebrospinal Fluid culture 
   5. Chest X-Ray 
   6. Surface swabs of mucous membranes 
7. Antimicrobial coverage
8. Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old
   1. https://doi.org/10.1542/peds.2021-052228
   2. 8-21 days 
   3. 22-28 days 
   4. 29-60 days 

References:

1. Neonatal Early Onset Sepsis Calculator - https://neonatalsepsiscalculator.kaiserpermanente.org/
2. AAP Guidelines for Evaluation and Treatment of a Well Appearing Febrile Infant 8-60 days old: https://doi.org/10.1542/peds.2021-052228

Links:

https://neonatalsepsiscalculator.kaiserpermanente.org/

About the Speaker:

Host: Elizabeth (Blair) Davis, MD – Elizabeth Blair Davis, MD, FAAP graduated from the University of Virginia School of Medicine and completed her pediatric residency at UVA. She received her undergraduate education from Washington and Lee University.

Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.