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Neonatal Sepsis

Neonatal Sepsis is a topic covered in the 5-Minute Emergency Consult.

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  • Life-threatening infection of the newborn, rarely occurring as late as 3 mo of age
  • Overwhelmingly bacterial:
    • Rarely viral or fungal infection
    • Organisms usually present in the maternal perineal flora
  • Occurs in 3–5 newborns per 1,000 live births
  • Risk factors:
    • Perinatal:
      • History of recent fever (>37.5°C)
      • UTI
      • Chorioamnionitis
      • Prolonged rupture of membranes (>18 hr)
      • Foul lochia
      • Uterine tenderness
      • Intrapartum asphyxia
    • Neonatal:
      • Prematurity
      • Fetal tachycardia (>180 beats/min)
      • Male
      • Twinning (especially 2nd twin)
      • Developmental or congenital immune defects
      • Administration of IM iron
      • Galactosemia
      • Congenital anomaly (urinary tract, asplenia, myelomeningocele, sinus tract)
      • Omphalitis


  • Bacterial:
    • Group B Streptococcus
    • Escherichia coli
    • Listeria monocytogenes
    • Coagulase-negative Staphylococcus
    • Treponema pallidum
  • Viral:
    • Herpes simplex is a common viral etiology.
    • Enterovirus
    • Adenovirus
  • Fungi:
    • Candida species
  • Protozoa:
    • Malaria
    • Borrelia

  • Bacterial:
    • Group B Streptococcus
    • E. coli type K1
    • L. monocytogenes
    • Other streptococci
    • Nontypeable Haemophilus influenzae
    • Coagulase-positive and coagulase-negative Staphylococcus
    • Less commonly: Klebsiella, Enterobacter
    • Pseudomonas, T. pallidum, and Mycobacterium tuberculosis
    • Citrobacter diversus (important cause of brain abscess)
    • Additional pathogens: Mycoplasma hominis and Ureaplasma urealyticum
  • Viral:
    • Enteroviruses
    • Herpes simplex virus (type 2 more commonly)
    • Cytomegaloviruses
    • Toxoplasma gondii
    • Rubella
    • HIV
  • Fungi:
    • Candida albicans and other fungi

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Rosen, Peter, et al., editors. "Neonatal Sepsis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307042/all/Neonatal_Sepsis.
Neonatal Sepsis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307042/all/Neonatal_Sepsis. Accessed April 24, 2019.
Neonatal Sepsis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307042/all/Neonatal_Sepsis
Neonatal Sepsis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307042/all/Neonatal_Sepsis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Neonatal Sepsis ID - 307042 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307042/all/Neonatal_Sepsis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -