Neonatal Pneumonia

y neonatal pneumonia, pulmonary and extrapulmonary injuries

are caused directly and indirectly by invading microorganisms or foreign material and by poorly targeted or inappropriate responses by the host defense system that may damage healthy host tissues as badly or worse than the invading agent.

y Prenatal features that suggest an increased risk for congenital

pneumonia include the following:

y Unexplained preterm labor y Rupture of membranes before the onset of labor y Membrane rupture more than 18 hours before delivery y Maternal fever (>38C/100.4F) y Uterine tenderness y Foul-smelling amniotic fluid

y Prenatal features that suggest an increased risk for congenital

pneumonia include the following: y Infection of the maternal genitourinary tract y Previous infant with neonatal infection y Nonreassuring fetal well-being test results y Fetal tachycardia y Meconium in the amniotic fluid y Recurrent maternal urinary tract infection y Gestational history of illness consistent with an organism known to have transplacental pathogenic potential

y Review antenatal screening tests for infection, such as

serologic tests for syphilis and birth canal tests forNeisseria gonorrhoeae, Chlamydia species, or group B Streptococcus, as well as any treatment courses and testing for cure.

Physical
y Persistent tachypnea (respiratory rate >60/min) y Expiratory grunting may occur. y Accessory respiratory muscle recruitment, such as nasal

flaring and retractions at subcostal, intercostal, or suprasternal sites, may occur y Cyanosis of central tissues, such as the trunk, implies a deoxyhemoglobin concentration of approximately 5 g/dL or more and is consistent with severe derangement of gas exchange from severe pulmonary dysfunction as in pneumonia,

y Systemic findings - Similar to signs and symptoms seen in y y y y y y y y

sepsis or other severe infections Temperature instability Skin rash Jaundice at birth Tachycardia Glucose intolerance Abdominal distention Hypoperfusion Oliguria