Introduction
Clinical
General
Specific
Diagnosis
Bacteriology
Management
References
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Early signs of sepsis are often non-specific in the neonate. Poor feeding, decreased activity and "not looking well" may be the only initial complaints. This is especially true of the VLBW infant. The most reliable clinical signs of sepsis from birth to 8 weeks are changes in affect, peripheral perfusion and respirations. Commonly present, but much less specific, are changes in feeding, activity, level of alertness and muscle tone.
Evaluation of newborns with suspected sepsis must include a careful search for a focus of infection. Conversely, when a focal infection is identified in a neonate, generalized sepsis should be looked for.
Serious bacterial infections are extremely uncommon in newborns without clinical evidence of illness. The exact incidence is unknown, but when it occurs it is in term babies with early-onset disease.
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