Neonatal Pneumonia

definsi
Pneumonia merupakan suatu proses
inflamasi yang dapat bersifat local
atau sistemik pada parenkim paru

 Gejala klinis sepsis, seperti; lethargy, refleks yang

buruk, hipotermia atau hipertermia, dan distensi
abdomen
Radiograf sugestif pneumonia (nodular atau
infiltrate patchy kasar, difus atau granularity, air
bronchogram, lobar atau konsolidasi segmental),
perubahan radiologi tidak kembali dalam waktu 48
jam
Layar sepsis Positif (salah satu dari berikut); Band
>20% dari leukosit, hitung leukosit dari kisaran
referensi, peningkatan protein C reaktif,
peningkatan sedimentasi eritrosit

Review of Systems

(-)
(-)
(-)
(-)
(-)
(-)
(-)

fever
change in sensorium
cough
colds
cyanosis
hematuria
seizures

diagnosis
Anamnesis
Sesak napas
Demam
Sulit ASI
Tampak lemah

Pemeriksaan fisik
Kesadaran
Kemampuan ASI
Gejala distres
pernapasan
Penurunan suara
paru
Demam dan sianosis

Pemeriksaan Penunjang
Radiologi
Kultur bakteri

Differential Diagnoses

Hyaline Membrane
Disease
Rule In: Patient was born preterm (34
weeks) with persistent cyanosis of
extremities, presented with occasional
grunting, subcostal retractions, crackles,
and tachypnea of 88 breaths per minute
on the first hours of life. The patient might
also had perinatal asphyxia due to difficult
delivery secondary to breech presentation.
Rule Out: The incidence of HMD
decreases significantly after 30-32 weeks
of gestation. The patient improved with
administration of antibiotics and oxygen.

Hyaline Membrane Disease

Evaluation: CXR is diagnostic and
shows diffuse atelectasis with an
increased density in both lungs and a
fine, granular, ground-glass appearance
of the lungs. The small airways are
filled with air and are clearly
surrounded by the increased density of
the pulmonary field, creating air
bronchograms.

Transient Tachypnea of the

Newborn
Rule In: Patient presented with tachypnea of
88 breaths per minute during the first 24 hours
of life, associated with grunting, subcostal
retractions, and persistent cyanosis of
extremities. Note of minimal improvement with
administration of oxygen support.
Rule Out: Physical examination revealed the
presence of crackles. Tachypnea did not resolve
within 24-48 hours of life.
Evaluation: CXR reveals prominent pulmonary
vascular markings, fluid in the intralobar
fissures, overaeration, and flat diaphragms.

Treatment
Early Onset infections (1st 7 days of life):
Ampicillin + Aminoglycosides
(Gentamicin)/ Cefotaxime
GBS- Penicillin G
MRSA- Vancomycin
Pseudominas Aminoglycosides +
Ceftazidime/ Piperacillin/ Ticarcillin/
Cabernicillin
C. trachomatis- Erythromycin/ TMP-SX