Sepsis Neonatal

Abstract

The case of a premature newborn, female, born by Caesarean section is presented; mother daughter 22 years old, with inadequate prental control. The patient is born at 24.1 weeks gestation determined by last date of menstrual period (LMP), by elective Cesarean presents anthropometry within normal percentiles; Apgar scores of 6-8, has good muscle tone, crying immediately, with a heart rate (HR) of 120 bpm, so the initial steps of reception takes place; 60 seconds HR decreases to 80 bpm so it proceeds administer positive pressure ventilation (PPV) with ambient oxygen; oral and nasal secretions aspirated favorable response. After 5 minutes presents spontaneous breathing, it is placed in nasal CPAP and is admitted to the neonatology service. It is kept in an incubator with ventilator support, oxygen therapy, parenteral nutrition, Rx pleuro evidence radiological signs of pulmonary hyaline membrane, normal capillary glycemia. The following day the patient evolves in regular conditions presenting distermias, signs suggestive of infection, blood gas reports decompensated metabolic acidosis, based on the patient's clinical and laboratory tests altered by antibiotic therapy is initiated clinical suspicion of sepsis. Subsequently, the patient does not evolve favorably, jaundice, bradypnea, tachypnea and dysthermia, several episodes of desaturation and apnea, new tests confirm the diagnosis of neonatal sepsis, so antibiotic therapy is rotated and placed on mechanical ventilation and is given vasoactive drugs: dopamine, dobutamine and adrenaline dose response. Despite the intensive management shows no favorable response. Blood culture report relates the growth of Klebsiella pneumoniae are welcomed. Patient does not respond to treatment and died within 8 days of life. Clinical evolution, interpretation of laboratory tests, treatment is discussed later do a detailed analysis of the risk factors, identification of critical points and establish improvement actions in this disease that leads to high morbidity and neonatal mortality.