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Sepsis Neonatorum

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sepsis neonatorum

sepsis neonatorum

Published in: Health & Medicine, Spiritual

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  • 1. SACRED HEART HOSPITAL DEPARTMENT OF PEDIATRICS Mortality and Morbidity Conference
  • 2. GENERAL DATA:
    • A case of Bb. Boy C.
    • Male neonate
    • Preterm, 33 weeks
    • Delivered via NSVD
    • AS=8,9
    • BW: 2kgs, AGA
  • 3. PRENATAL HISTORY:
    • Mother was 29 years old
    • G2P1001
    • 1 st PNC at 2 mos AOG with regular subsequent visits thereafter
    • Multivitamins was taken with good compliance
    • No maternal illness
    • Maternal bloodtype: O(+)
  • 4. Natal History
    • Preterm, 33 weeks, AGA
    • By a private OB via NSVD
    • With good cry, no cyanosis, AS: 8,9
    • PE:
    • HR: 160 RR: 65 Temp:36.2 C
  • 5.
    • HC: 31.5 cm (P>50) CC: 28cm AG: 25.5
    • BL: 46 cm (P25) BS: 33 weeks
    • BW: 2kgs (P75)
    • BR: 2/2
  • 6.
    • Skin: with superficial peeling, warm, good turgor
    • HEENT: normocephalic, no caput, pinkish palpebral conjunctivae, anicteric sclerae, sl. curved pinna, soft with recoil, no alar flaring, moist tongue & lips
  • 7.
    • Chest & lungs: equal chest expansion, no retractions, clear breath sounds
    • Heart: distinct heart sounds, regular rate & rhythm, no murmur
    • Abdomen: globular, umbilicus at midline with 2 arteries & 1 vein, normoactive bowel sound, soft
  • 8.
    • Genitalia: testes descending, few rugae
    • Ext: warm, strong pulses
    • Impression: Preterm, 33 weeks, male neonate, del via NSVD, AS 8,9, AGA, BW: 2 Kgs
  • 9. Course in the Ward:
    • On admission:
    • NPO temporarily
    • CBC
    • Blood Typing: “B” (+)
    • HGT at 2 hours Old requested
    • D10W (70 cc/kg/D)
    • Vit K 1mg IM was given
    • Terramycin eye ointment, OU given
  • 10.
    • Attached to pulse oximeter
    • O2 inhalation at 2 LPM via nasal cannula
    • Routine Newborn Care done
    • Referred to a neonatologist for co-management
  • 11. 2 hours after birth
    • HGT at 2 hours Old : 33 mg/ dL
    • D10W 4cc was given as IV bolus (2cc/kg)
    • Repeat HGT after 30mins: 90 mg/dL
  • 12. 4 hours after birth
    • CXR-APL view done : essentially negative heart and lungs
    • Blood culture: No growth
    • Ampicillin 100mg IVTT q12hrs(AD:100mKD)
    • Amikacin 20mg IVTT q24hrs(AD:10mKD)
  • 13. 7 hours after:
    • O2 inhalation decreased to 1.5LPM
  • 14. 1 st Hospital Day:
    • O2 inhalation PRN
    • TBDB
    • Phototherapy started
    • D10 IMB (80cc/K/D)+Ca Gluc+20%
    • O2 at 0.5 LPM – occ’l desaturation O2 sat(92 – 99%)
    • RR: 50’s -60’s HR:130 Temp:37.2
    • O2 sat: 92 – 100%
  • 15. 2 nd Hospital Day:
    • D10 IMB (90cc/K/D)+Ca Gluc+20%
    • Ampi and Amik going Day 4
  • 16. 3rd Hospital Day:
    • Jaundice noted down to lower extremities
    • Feeding started at 5cc milk formula or direct breastfeeding
    • Ampi and Amik – going Day 5
    • Pulse oximeter d/c
  • 17. 4th Hospital Day:
    • D10 IMB (110cc/K/D)+Ca Gluc+20% - po(80)
    • Ampi and Amik going Day 6
    • Dropper feeding increased to 15 cc q3hrs
  • 18. 5th Hospital Day:
    • IVF shifted to heplock
    • Ampi and Amik going Day 7
    • D10 IMB (120cc/K/D)+Ca Gluc+20% - po(120)
    • Provital drops, 0.5 mL OD po started
    • Folic acid 5 mg tab, 0.1mg papertab OD po
  • 19. 6th Hospital Day:
    • TBDB:
    • TB: 8.95
    • DB: 0.57
    • IB: 8.38
    • CBC prior to discharge
  • 20. 7th Hospital Day:
    • MGH
    • Vit k 1mg IM given
    • THM:
    • Provital Drops, 0.5 mL OD P.O
    • Folic Acid 5mg tablet, 0.1 mg papertab OD po
    • TBDB:
    • TB: 7.75
    • DB: 0.50
    • IB: 7.25
  • 21.
    • Preterm 33 weeks, delivered via NSVD, male neonate, AS=8,9, BW=2kgs, AGA,
    • Sepsis neonatorum, unspecified