The neonatal pneumonia is a lung infection of the newborn. You may, within the first few hours after birth, and during sepsis, or 7 days later occur and affect only the lungs. Clinically only a shortness of breath or in the course can also shock and death may occur. The diagnostics correspond to the measures in suspected sepsis. The antibiotic treatment is carried out initially at first wide, but is then treated pathogen-specific as soon as possible.
The most common invasive infection after primary sepsis is pneumonia. The early pneumonia occurs as a side effect of a generalized septicemia at birth or hours later (see Fig. Sepsis in newborns). The late pneumonia usually occurs after 7 days, mostly among children in pediatric intensive care units who were intubated because of a lung disease.
The neonatal pneumonia is a lung infection of the newborn. You may, within the first few hours after birth, and during sepsis, or 7 days later occur and affect only the lungs. Clinically only a shortness of breath or in the course can also shock and death may occur. The diagnostics correspond to the measures in suspected sepsis. The antibiotic treatment is carried out initially at first wide, but is then treated pathogen-specific as soon as possible. The most common invasive infection after primary sepsis is pneumonia. The early pneumonia occurs as a side effect of a generalized septicemia at birth or hours later (see Fig. Sepsis in newborns). The late pneumonia usually occurs after 7 days, mostly among children in pediatric intensive care units who were intubated because of a lung disease. Etiology The germs usually originate from the mother’s birth canal or from the children’s ward. These include gram-positive bacteria (eg. B. streptococci of group A and B, both methicillin-susceptible and methicillin-resistant Staphylococcus aureus) and gram-negative bacteria (for. Example, Escherichia coli, Klebsiella sp., And Proteus sp.). In children who have received broad spectrum antibiotics, many bacteria can be found, for example. As Pseudomonas, Citrobacter, Bacillus, and Serratia. A cases are caused by viruses or fungi. Symptoms and discomfort late onset, caused by hospitalization, pneumonia manifested (thick and brown z. B.) by an inexplicable deterioration of the patient’s respiratory function and increased secretion and qualitative change in the secretions. The infants may be acutely ill, connected to temperature instability and neutropenia. Diagnostic X-ray of the breast The evaluation includes chest X-ray, pulse oximetry, blood cultures, Gram stain and cultures of tracheal aspirate. In thoracic radiograph new, persistent infiltrates should be visible, but they can be in the presence of severe bronchopulmonary dysplasia difficult to detect. If the Gram staining shows a significant number of polymorphonuclear leukocytes and represents a single organism that is in conformity with that which has grown from the culture of tracheal aspirate, increases the likelihood that this organism is the cause of pneumonia. Since bacterial pneumonia in newborns can disseminate. A complete evaluation of sepsis, among other means Lumpalpunktion should be made. However, blood cultures are positive in only 2-5% of cases of nosocomial pneumonia. Treatment In general, vancomycin and a broadband ?-lactam antibiotic is The antimicrobial therapy in the early-onset form similar to that of neonatal sepsis. Vancomycin and broadband ?-lactam antibiotic such as meropenem, Iperacillin / tazobactam or cefepime (see Table: Recommended doses of selected pareneraler antibiotics for newborns) are the drug of first choice in most late-onset nosocomial pneumonia. This method treats sepsis and pneumonia with typical nosocomial pathogens, including P. aeruginosa. Local patterns of infection and bacterial resistance should always be used to help with the empirical choice of antimicrobial agents. Specific antibiotics are used for a antibiogram. The treatment is the same as a neonatal sepsis. Chlamydia pneumonia Exposure to chlamydia can lead during childbirth to develop a Chlamydia pneumonia at the age of 2-18 weeks after birth. The children are tachypneic, but not seriously ill and may conjunctivitis with the same pathogen have. Eosinophilia may be present. In thoracic overview you can see both sides interstitial infiltrates with hyperinflation. Erythromycin therapy Treatment with erythromycin leads to quick success (see table: Recommended dosage of selected oral antibiotics for newborns *). Since erythromycin may cause hypertrophic pyloric stenosis (HPS) in newborns, all newborns treated with erythromycin, be monitored for symptoms of HPS should. Her parents should be informed about possible risks. Azithromycin 20 mg / kg p.o. over 3 days can also be effective 1 times daily. The diagnosis of pneumonia due to Chlamydia trachomatis should consider clarification of the mother and her partner to be because an untreated chlamydial infection may have maternal complications such as pelvic inflammatory disease and sterility.