Neonatal Pneumonia

Illustration
Etiology
risk factors for neonatal infection
Symptoms, Signs, and Diagnosis
Treatment
 Illustration

Neonatal pneumonia is lung infection in a

neonate.
Onset may be within hours of birth and part of a
generalized sepsis syndrome, or after 7 days
and confined to the lungs.
The incidence of pneumonia in the newborn is
relatively high – 1~2‰. The pneumonia in a
neonate is usually of bacterial origin.
 Illustration
 Early-onset pneumonia is part of generalized sepsis
that presents at or within hours of birth.
 Late-onset pneumonia usually occurs after 7 days of
age, most commonly in neonatal ICUs in infants who
require prolonged endotracheal intubation because
of lung disease.
 Etiology
 Bacterial organisms :
• group B streptococci
• gram-negative bacilli including E. coli, Klebsiella, and
Pseudomonas
• listeria
• Staphylococcus species
• other rarer bacterial pathogens include anaerobiotic
bacilli and Chlamydia
 Etiology

 Nonbacterial pathogens
• mycoplasma pneumonia
• candida albicans
• cytomegalovirus
• pneumocystis carinii
 Symptoms, Signs, and Diagnosis
 Early symptoms include:
• Lethargy
• Apnoea
• Bradycardia
• Poor feeding - there may be temperature
instability
• on examination, there may be diminished air
entry over areas of consolidation or effusion.
 Symptoms, Signs, and Diagnosis

 Late-onsethospital-acquired pneumonia
may begin gradually, with more secretions
being suctioned from the endotracheal
tube and higher ventilator settings.
 Symptoms, Signs, and Diagnosis

 Features which are used to define

respiratory distress include:
 respiratory rate of greater than 60/min for more
than an hour
 grunting expiration
 subcostal or sternal recession on inspiration
 flaring of the nasal alae
 with or without cyanosis in air - increased oxygen
requirement
 Investigations

 septic screen in neonates

 full blood count
 urea and electrolytes, with glucose estimation
 blood culture
 chest radiology
 lumbar puncture
 Chest X-ray

Spot laminated shape

Figure 1. Note asymmetric coarse Figure 2. Note diffuse fine
patchy infiltrates. granular infiltrates.
.
 Treatment

 Antibiotics:
 In early-onset sepsis, initial therapy should
include ampicillinor penicillin G plus an
aminoglycoside.

 In late-onset hospital-acquired sepsis, initial

therapy should include vancomycin plus an
aminoglycoside.

 Ceftazidime ,ceftriaxone
Erythromycin;
mycoplasma pneumonia
Chlamydia pneumonia

Antifungusagent: candida albicans

Flaconazole
Ketoconazole
 Treatment

 The other treatment:

• Keep warm
• Feeding
• Oxygen
• Fliud