Description

McGuire et al listed clinical and laboratory findings which may be indications of a late onset infection in a hospitalized preterm neonate. Prompt recognition and therapy can reduce complications but may be hampered by subtle findings. The authors are from the University of Dundee and Ninewells Medical School in Dundee.


 

Risk factors:

(1) extreme prematurity

(2) ventilatory support

(3) intravascular catheters

(4) urinary catheter

 

Clinical findings:

(1) lethargy

(2) hypotonia

(3) abdominal distention

(4) feeding intolerance

(5) increasing apnea

(6) increased respiratory distress and need for respiratory support

(7) fever, hypothermia or unstable temperature

 

Laboratory findings:

(1) hyperglycemia

(2) leukocytosis

(3) unexplained metabolic acidosis

 

Radiographic findings:

(1) pulmonary infiltrate

 

Problems in diagnosis:

(1) false negative cultures

(2) false positive cultures

 


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