Suspected Neonatal Sepsis

Male infant with h/o prematurity, perinatal asphyxia presents with respiratory distress and seizures s/p cyanotic episode. Demonstrated poor feeding prior to symptom onset. Maternal h/o UTI, GBS+, prolonged ROM, chorioamnionitis during pregnancy/delivery. Temperature and blood pressure instability, poor perfusion, petechiae, and lethargy on exam.

• Obtain blood culture, CSF culture

• 3 or more risk factors as mentioned above: Empiric ampicillin/gentamicin x 72 hours while awaiting blood culture results

• Continue antibiotics x 14 days if blood cultures positive

• NICU alerted and will accept transfer of care

Note: Most common causes of neonatal sepsis (in order of prevalence) include

• Group B strep

• E. coli

• Listeria