Neonatal sepsis specifically refers to the presence of bacterial infection in the blood stream of neonates (newborn) in a neonate (newborn). This may result from or in infections such as meningitis, pneumonia, pyelonephritis, or gastroenteritis in the setting of fever. Neonatal sepsis is divided into two categories: early-onset sepsis (EOS) and late-onset sepsis (LOS). EOS refers to sepsis presenting in the first 7 days of life with LOS referring to presentation of sepsis after 7 days (or 72 hours, depending on the system used).

It is difficult to clinically exclude sepsis in newborns less than 90 days old that have fever (defined as a temperature > 38°c. Except in the case of obvious acute viral brochiolitis, the current practice in newborns less than 30 days old is to perform a complete workup including complete blood count with differential, blood culture, urinalysis, urine culture, and cerebrospinal fluid (CSF) studies and CSF culture, admit the newborn to the hospital, and treat empirically for serious bacterial infection for at least 48 hours until cultures are demonstrated to show no growth.

Signs and symptoms

The signs of sepsis are non-specific and include:

  • Body temperature changes
  • Breathing problems
  • Diarrhea
  • Reduced movements
  • Reduced sucking
  • Seizures
  • Slow heart rate
  • Swollen belly area (redness around the umbilicus extending into the skin)
  • Vomiting
  • Yellow skin and whites of the eyes (jaundice)
  • Low blood sugar

Note that, in neonates, sepsis is difficult to diagnose clinically. They may be relatively asymptomatic (showing no symptoms) until hemodynamic (blood flow) and respiratory collapse is imminent, so, if there is even a remote suspicion of sepsis, they are frequently treated with antibiotics empirically until cultures are sufficiently proven to be negative.

We advise you contact the Paediatric unit for proper treatment and medication if you notice any unusual signs or symptoms in your baby.