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26 Cards in this Set
- Front
- Back
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Organisms - neonates
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Group B strep
E coli and other enteric gram negatives Strep pneumo Neisseria meningitidis Haemophilus influenza Listeria |
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Organisms - infants
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8% serious infections - mostly UTI
2% meningitis 80% gram negatives - E coli most common |
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Group B strep - epidemiology
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Commonly found in vagina and rectum
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Group B strep - virulence factors
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Surface protein
Penicillin binding protein for resistance |
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Group B strep - early phase
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Less than 7 days
Pneumonia Respiratory failure BSI |
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Group B strep - early phase risk factors
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Positive vaginal culture at delivery
Low birth weight Prematurity Intrapartum fever Ruptured membranes Intrauterine instrumentation |
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Group B strep - late phase
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7 days to 7 months
Gradual symptoms Bacteremia Meningitis |
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Group B strep - late phase risk factors
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Prematurity
Positive maternal rectal or vaginal culture African-American |
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E coli - early onset
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Poor feeding
Abdominal distention Irritability Low-grade fever Hypothermia Bradycardia Respiratory distress Cyanosis |
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E coli - late onset
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Same as early, but with jaundice
Can get meningitis, seizures, and bulging fontanelle |
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Workup - infants < 30 days
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CBC
Blood and urine cultures CSF exam Empiric therapy with ampicillin and cefotaxime |
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Workup - 30-90 days
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Less aggressive
More aggressive with high fever, elevated WBCs, or toxic appearance |
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Vesicles
Ulcerative skin lesions Conjunctivitis Keratitis |
Neonatal HSV
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Neonatal HSV - epidemiology
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Mostly HSV-2
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Neonatal HSV - CNS disease
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Encephalitis and meningitis
Fever and lethargy Seizures CSF with mononuclear cells, low glucose, and elevated protein |
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Neonatal HSV - disseminated
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Multiorgan involvement - brain, liver, lung, skin, and adrenals
Mimics bacterial sepsis - jaundice, coagulopathy, hemodynamic instability, neurologic deterioration |
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Neonatal HSV - risk factors
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Primary infection at delivery
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Neonatal HSV - treatment
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Acyclovir
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Poor feeding
Irritability Diarrhea and abdominal distention Rash |
Enterovirus
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Enterovirus - epidemiology
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Coxsackie virus A and B
Summer and fall epidemics If entering baby's bloodstream from mother's blood, can disseminate, causing necrosis and DIC |
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Enterovirus - diagnosis
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Culture of blood, CSF, stool, and throat
PCR of serum and CSF |
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Enterovirus - treatment
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Pleconaril
Handwashing |
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Hep B virus - transmission
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Amniotic fluid
Vaginal secretions Blood during delivery Transplacentally Breast milk |
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Hep B virus - signs
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Replication in liver
Elevated liver enzymes |
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Hep B virus - diagnosis
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Antigen in serum
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Hep B virus - therapy
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Alpha interferon
Vaccination 12 hours after birth |
