The immune system of the human body is responsible for defending the body against outside agents which may cause infection. The immune system of a newborn is fairly weak and takes time to develop - this leaves the newborn open to several possible infections. It is for this reason that healthcare providers ensure that the baby is not exposed to any potential infections.
What is Sepsis?
In case a baby contracts an infection, the immune system will respond by fighting the causative agents. However in case of sepsis, the immune system responds abnormally and begins to attack the healthy cells and tissues in the body.
In neonatal sepsis, the normal immune system response is sent into overdrive, causing a blood condition which is potentially harmful to the baby’s health. It involves the production of excessive white blood cells to fight the infection. This usually occurs before the baby is 90 days old.
What Causes Sepsis in Newborns?
The primary sepsis infection is usually bacterial in nature, but in rare cases it could also be due to a viral or fungal infection. It is nearly always passed on from the pregnant mother to the baby, however it can (less commonly) be picked up by from immediate environment.
Bacteria that are known to cause sepsis in newborns include E.coli, group B Streptococcus, Neisseria meningitidis, Salmonella, Haemophilus influenzae type b, and Listeria monocytogenes. The Herpes Simplex virus family may also cause the infection. An existing medical condition may also trigger sepsis.
What are the Symptoms of Sepsis?
Depending on the type and severity of the infection, neonatal sepsis may exhibit a variety of symptoms. Some of these are listed below.
- Reduced appetite and reluctance to feed. Not drinking for more than 8 hours.
- Tendency to vomit after feeding.
- High body temperature, above 100.4 degree Fahrenheit.
- Increased irritability and cranky behavior.
- Lethargic movements or floppy motions.
- Change in heart rate, both higher and lower rates possible depending on infection stage.
- A problem in taking breaths.
- Change in skin tone, pale and patchy skin.
- Eyes and skin may look yellow due to jaundice. Eyes may have a sunken appearance.
- Decrease in urination - not passing urine in more than 12 hours.
- A swelling in the stomach region.
- Bulging of the fontanelle.
- A decrease in blood pressure.
- Reduction of blood platelet count.
Should the newborn exhibit more than two of these symptoms, it is advisable to get the opinion of a doctor. Since sepsis is a rapidly progressing condition, delayed treatment may cause permanent harm to the growth and development of the baby.
Risk Factors for Developing Sepsis
Complications during pregnancy and after birth may create high risk conditions for neonatal sepsis. These include a prior infection of the pregnant mother, or a subsequent infection the baby picks up. The baby may develop any of these conditions, eventually leading to sepsis.
- Pneumonia (lung infection)
- Peritoitis (stomach lining infection)
- Urinary tract infection
- Cholecystitis (gall bladder infection)
- Cholangitis (bile duct infection)
- Cellulitis (skin infection)
- Meningitis (brain infection)
- Encephalitis (nervous system infection)
- Osteomyelitis (bone infection)
- Endocarditis (heart infection)
Sepsis can be caused by bacterial, viral or fungal infection. However the majority of sepsis cases on record are caused by pneumonia, abdominal infection, kidney infection, and bacteremia or bloodstream infections.
Complications of Sepsis
The immune system helps to isolate an infection and limit it to the tissues already affected. A number of white blood cells travel to the infected tissue to combat the root agent of the infection. The biological process which follows includes the swelling of the affected tissue and is called inflammation.
A weak immune system is unable to isolate the infection, allowing it to spread to other organs and tissues. This overwhelms the immune system and inflammation sets in all over the body. The tissue and organ swelling slows down the blood flow, and therefore, oxygen doesn’t reach the tissues and eventually leads to a drop in blood pressure.
Multiple organ failure will follow if this is not detected and treated in time. The dropping of blood pressure is known as septic shock. It is a critical condition and can be fatal if the doctor does not administer antibiotics and large quantities of intravenous fluids to flush out and fight the infection in the blood.
If diagnosed in time, and treated correctly, the baby will make a full and complete recovery from neonatal sepsis. However in cases of septic shock, the survival rate is less than fifty percent. Additionally, severe sepsis puts the child at greater risk for infections in the future.
Reviewed by Afsaneh Khetrapal BSc (Hons)