Neonatal infection

Clinical features

• Irritability, lethargy, poor feeding
• Temperature changes (fever and hypothermia both possible)
• Cardiocirculatory: tachycardia, hypotension, poor perfusion, and delayed capillary refill > 3 sec
• Respiratory: tachypnea, dyspnea (e.g., expiratory grunting), apnea (more common in preterm infants)
• Skin tone: jaundiced and/or bluish-gray (indicates poor perfusion)

Complications

• Critical illness polyneuropathy (CIP)
  • Definition: axonal injury, particularly to the motor neurons, as a sequela of sepsis and multiple organ dysfunction
  • Clinical features
    • Predominantly distal, symmetrical, flaccid paralysis of the extremities with muscle atrophy; may affect the diaphragm
    • Absent or reduced reflexes
    • Dysesthesias in a glove-and-stocking distribution may be present
• Critical illness myopathy (CIM), which results in a decrease of muscle membrane excitability and loss of myosin with resultant atrophy of myofibers