Scribd Logo
Upload

Welcome to Scribd!

  • 2K views

    Identification and Classification of Neonate With Infections

    Uploaded by

    visuinsvu
    1. Neonatal conjunctivitis, also known as ophthalmic neonatorum, refers to swelling or infection of the eyelids in newborns, usually caused during birth by infected vaginal discharge from the mother. 2. Congenital syphilis occurs when the Treponema pallidum bacterium is transmitted from an infected pregnant woman to her fetus, potentially resulting in stillbirth, prematurity, or a variety of clinical manifestations. 3. Risk factors for congenital syphilis include lack of or inadequate prenatal care, maternal substance abuse, and failure to repeat serological testing in the third trimester. Transmission can occur sexually, trans-placentally,

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd

    Identification and Classification of Neonate With Infections

    Uploaded by

    visuinsvu
    2K views62 pages
    1. Neonatal conjunctivitis, also known as ophthalmic neonatorum, refers to swelling or infection of the eyelids in newborns, usually caused during birth by infected vaginal discharge from the mother. 2. Congenital syphilis occurs when the Treponema pallidum bacterium is transmitted from an infected pregnant woman to her fetus, potentially resulting in stillbirth, prematurity, or a variety of clinical manifestations. 3. Risk factors for congenital syphilis include lack of or inadequate prenatal care, maternal substance abuse, and failure to repeat serological testing in the third trimester. Transmission can occur sexually, trans-placentally,

    Original Description:

    IDENTIFICATION AND CLASSIFICATION OF NEONATE WITH INFECTIONS

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1. Neonatal conjunctivitis, also known as ophthalmic neonatorum, refers to swelling or infection of the eyelids in newborns, usually caused during birth by infected vaginal discharge from the mother. 2. Congenital syphilis occurs when the Treponema pallidum bacterium is transmitted from an infected pregnant woman to her fetus, potentially resulting in stillbirth, prematurity, or a variety of clinical manifestations. 3. Risk factors for congenital syphilis include lack of or inadequate prenatal care, maternal substance abuse, and failure to repeat serological testing in the third trimester. Transmission can occur sexually, trans-placentally,

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    2K views62 pages

    Identification and Classification of Neonate With Infections

    Uploaded by

    visuinsvu
    1. Neonatal conjunctivitis, also known as ophthalmic neonatorum, refers to swelling or infection of the eyelids in newborns, usually caused during birth by infected vaginal discharge from the mother. 2. Congenital syphilis occurs when the Treponema pallidum bacterium is transmitted from an infected pregnant woman to her fetus, potentially resulting in stillbirth, prematurity, or a variety of clinical manifestations. 3. Risk factors for congenital syphilis include lack of or inadequate prenatal care, maternal substance abuse, and failure to repeat serological testing in the third trimester. Transmission can occur sexually, trans-placentally,

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 62

    IDENTIFICATION AND CLASSIFICATION OF

    NEONATE WITH INFECTIONS

    PRESENTED BY:
    K. SUREKHA

    Definition of immunity
    Immunity is a biological term that describes a state of having sufficient biological

    defenses to avoid infection, disease, or other unwanted biological invasion.

    TYPES OF IMMUNITY

    PREDISPOSING FACTPRS FOR NEONATAL INFECTIONS


    Low birth weight / prematurity Contaminated environment in uterus Infected birth passages

    Congenital anomalies
    Hospital procedures Artificial feeding

    CLASSIFICATION OF NEWBORN INFECTIONS


    Intrauterine infections: it refers to infection acquired in utero. The TOURCH a group of infections (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus)

    belonging to this category.

    Cont
    Perinatal infections: in refers to infection that is

    acquired just before pregnancy and during delivery


    from the mother. Such an infection occurs from the organisms colonizing the birth passage. Early neonatal infection: should be limited to perinatal infection with manifestations occurring within 72 hours of birth.

    Cont
    Late onset neonatal infection: it is sepsis occurring after 8th day of birth. Post neonatal infection: it refers to infections occur after 28 days of delivery. The organisms responsible for post neonatal infections are Staphylococcus areus, klebsialle Proteus, E.coli,

    salmonella pseudomonas, Candida albicans.

    Based on the causative organisms

    Bacterial infections Viral infections

    Protozoa infections
    Fungal infections

    HIV AND AIDS

    HIV AND AIDS


    In 2009, the World Health Organization (WHO) estimated that there are 33.4 million people worldwide living with HIV/AIDS, with

    2.7 million new HIV infections per year and


    2.0 million annual deaths due to AIDS

    CONT

    At the end of 2010, there were 3.4 million children living with HIV around the world. An estimated 390,000 children became newly infected with HIV in 2010.

    Definition:
    An infectious disease of the immune system
    caused by a human immunodeficiency virus

    (HIV). AIDS is characterized by a decrease in


    the number of helper T cells, which causes a severe immunodeficiency that leaves the body susceptible to a variety of potentially fatal infections.

    The dictionary.com

    Definition:
    A disease of the immune system characterized by increased susceptibility to opportunistic infections, as pneumocystis carinii pneumonia and candidiasis, to certain cancers, as Kaposi's sarcoma, and to neurological disorders caused by a

    retrovirus.
    -PUB MED

    HUMAN IMMUNODEFICIENCY VIRUS

    Rotes of transmission of HIV:


    Blood

    Breast milk

    Semen

    Preejeculate

    Vaginal fluid

    Risk factors of pediatric AIDS include:


    Mothers who addicted with intravenous drugs. Mothers who indulge in prostitution. Mothers who are heterosexual with bisexual husbands. A history of blood transfusion with blood or its products including factor-8 concentrates with in preceding 5 years. A history of residence in certain geographical areas that are inhabited considerably with aids patients.

    Timing of maternal infant transmission


    Intrauterine: 25-40% Intrapartum: 60-75%. Added risk of breast -feeding: 12-14%.

    MATERNAL TRANSMISSION OF HIV

    CLINICAL

    MANIFESTATIONS:

    Differences in pediatric and adult HIVinfection: Overall progression of disease is more rapid in children Immune system is more immature with adults. CD4+ counts Recurrent invasive bacterial infections are more common in children Disseminated CMV, Candida, Herpes Simplex and Varicella Zoster are more common LIP occur almost exclusively in children

    CNS infections are common


    Peripheral neuropathy, Myopathy is rare in children.

    WHO - CLINICAL STAGING SYSTEM


    CLINICAL STAGE I Asymptomatic General Lymphadenopathy

    CONT.
    CLINICAL STAGE II Diarrhea >30 days Sever persistent or recurrent diarrhea outside neonatal period. Weight loss failure to thrive

    Persistent fever >30 days


    Recurrent sever bacterial infection other than

    Septicemia or Meningitis. (e.g. Osteomylitis, Abscess,


    Bacterial Pneumonia-non tubercular)

    CONT.
    CLINICAL STAGE III

    AIDS defining opportunistic infections.


    Sever failure to thrive.

    Progressive Encephalopathy.
    Malignancy.

    Recurrent Septicemia or Meningitis.

    MANAGEMENT
    Zudovidine(ZDV,AZT)- 90-180mg/m2 6-8 hr Lamivudine(3TC) -4mg/kg BD Didanosine (ddL) 90-150 mg/kg 12 hrly Stavudine(d4D)-1mg/kg 12 hrly Abacavir(ABC)-8mg/kg 12hrly Zalcitabine(ddc)-0.005-0.01mg/kg 8 hrly

    IMMUNIZATION
    HIV-exposed children should be immunized according to the routine national immunization schedule with the following notes: BCG should not be given in symptomatic HIVinfected children. HiB vaccine should be given to all who are confirmed HIV-infected on the basis of 2

    CONT
    Positive DNA PCR tests done at 6 weeks of age. Additional vaccines such as

    Pneumcoccal, Varicella, Hepatitis A, Influenza Virus etc. may be given as necessary.

    Vitamin A supplementation should be as per the UIP

    schedule.

    NURSING MANAGMENT
    Acceptable, Feasible,
    Affordable, Sustainable and Safe, avoidance

    OPHTHALMIC
    NEONATRUM

    Definition
    Ophthalmic neonatorum was the term used to describe a hyper

    acute purulent conjunctivitis, usually caused by gonococcus, in


    the first 10 days of life. -WHO Ophthalmic neonatrum was the term used that any hyper acute purulent conjunctivitis occurring during the first 10 days of life, usually contracted during birth from infected vaginal discharge of the mother. -MedicalDictionary

    Cont
    Neonatal conjunctivitis is swelling (inflammation) or infection of the tissue

    lining the eyelids in a newborn.


    According to Pub Med

    Causes:
    Non infectious Infectious

    pathophysiology
    Inflammation of conjunctiva

    Blood vessel dilation & chemosis

    Absence of tears at birth

    A newborn with gonococcal ophthalmic neonatorum.

    Swelling and purulent drainage

    Hyperemic & Chemosis of conjectiva

    Diagnostic studies:
    Culture of the drainage from the eye to look for bacteria or viruses

    Slit-lamp examination to look for damage to


    the surface of the eyeball

    Prophylaxis
    Antenatal Natal Postnatal measures 1% tetracycline / 0.5% erythromycin / silver nitrate solution ointment. Ceftriaxone 50mg/kg IM or IV

    NURSING CARE:
    Principles of cleanliness at childbirth Clean hands

    Clean perineum
    Nothing unclean introduced vaginally

    Clean delivery surface


    Cleanliness in cord clamping and cutting

    Cleanliness for cord care

    CONGENITAL
    SYPHILIS

    DEFINITION
    Congenital syphilis occurs when the spirochete
    Treponema palladium is transmitted from a pregnant woman to her fetus. Infection can result in stillbirth, prematurity, or a wide spectrum of clinical

    manifestations; only severe cases are clinically apparent at birth.


    -WHO

    RISK FACTORS
    A baby has an increased risk of developing congenital syphilis if the mother: Lack of or inadequate prenatal care. Maternal substance abuse. Failure to repeat a serological test for syphilis in the third

    trimester.
    Treatment failure. Inadequate access to Sexually Transmitted Diseases (STD)

    clinics and STD outreach activities.

    MODES OF TRANSMISSION:
    Sexual contact.

    Trans-placental passage from infected


    mother.

    Contact with lesion at the time of delivery.


    The risk of developing syphilis after

    exposure is about 40%.

    TYPES:
    ACQUIRED SYPILIS CONGENITAL SYPHILIS

    CLASSIFICATION:

    EARLY: It occurs in children between 0 and 2 years old.

    LATE: Late congenital syphilis is a subset of


    cases of congenital syphilis

    PATHOPHYSIOLOGY
    Initial invasion through mucous membranes or skin The organism rapidly multiplies and widely disseminates Organism spreads through the perivascular lymphatics Primary clinical manifestations

    Hutchinson's trait

    Scarring skin around the mouth & nasal discharge

    Secondary lesions on feet

    Lesions on face

    Hutchinson's teeth (Abnormal notched and peg-shaped, blunted upper incisor teeth)

    Saddle nose (collapse of the bony part of nose)

    Clutton's joints (swelling of joints)

    Sabre shins

    Osteochondritis of distal radius and ulna

    Osteochondritis of femur and tibia metaphysis

    Papulosquamous Plaques

    CSF abnormalities may occur in congenital syphilis Even in absence of neurologic involvement. * Leukocytosis * Elevated protein in CSF * positive VDRL (no false positives)

    TREATMENT
    Proven or highly probable:

    Aqueous crystalline Penicillin G 100,000-150,000U/kg/day (given q8-q12hrs) IV for 10 days OR Procaine Penicillin G 50,000 U/kg/day IM for 10days
    If >1 day of therapy missed, entire course should be restarted!

    Asymptomatic, Normal CSF exam, CBC, platelets, and Radiologic exam: 1. No maternal tx aqueous PCN G IV for 10-14 days 2. Tx w/ Erythromycin clinical, serologic follow-up, and Benzathine Pcn G IM x 1 3. Tx < 1month before Delivery, or <4 fold Decrease in titers clinical, serologic follow-up and Benzathine Pcn G IM x 1

    Treat all newborns w/ positive VDRL as if they have


    congenital syphilis, even if mother thought to not have an active infection.

    1.

    Difficult to document that mother received adequate tx,


    and has falling VDRL titer.

    2. Low titer VDRL test may be compatible with latent maternal syphilis. 3. Newborn may not have clinical manifestations at birth. 4. Compliance with follow-up visits may be problem.

    Follow-up
    Should have careful follow-up examination at
    1, 2, 4, 6, and 12 months of age. Serologic non-treponemal tests: 3, 6, 12 months, and end of tx (or until non-reactive) Non-treponemal Ab titers decline by 3 months of age, and Should be Non-reactive by 6 months, if infant was not infected. (transplacentally aquired antibodies.)

    If persistent, stable titers, consider retreatment.


    Congenital neurosyphilis- CSF exam at 6 month intervals until normal

    You might also like