1. INFECTIONS OF THE NEWBORN

3. OPHTHALMIA NEONATORUM
DEFINITION
Ophthalmia neonatorum is defined as inflammation of conjunctiva during first 3 weeks of life

4. CAUSES
Gonococcus
Chlamydia trachomatis
Bacterial
Chemical
Viral

5. MODE OF INFECTION During delivery by contaminated vaginal discharge
More common in face and breech presentation

6. CLINICAL MANIFESTATION
Watery discharge
Mucopurulent to frank purulent in one or both eye

7. PREVENTION Antenatal infection should be treated
Maintain asepsis at birth
Sulphacetamide eye drop or soframycin eye drop

8. INVESTIGATION Gram stain smear Culture and sensitivity
Scraping material from lower conjunctiva

9. TREATMENT Gonococcal Irrigate eyes with isotonic saline until clear
Gentamycin eye drop
Benzyl penicillin u/kg or
Cefotaxime 100 mg/kg
Chlamydia
Erythromycin suspension 40mg/kg
Erythromycin ophthalmic ointment
Herpes simplex
Acyclovir 30 mg/kg

10. SKIN INFECTION PEMPHIGUS NEONATORUM Caused by staphylococcus aureus
May cause septicaemia or pyremia
Superficial blister appear become pustule and then burst

11. PEMPHIGUS NEONATORUM….Contd
PREVENTION
Avoid bath
Keep babies separate in nursery
Manage the source
MANAGEMENT
Isolation
Prick the needle with sterile needle removal of the dead skin
Smear with antibiotic ointment
Administer erythromycin 25 mg/kg or cloxacillin 50 mg/kg

12. UMBILICAL SEPSIS(OMPHALITIS)
CAUSATIVE ORGANISM
Staphylococcus
E.Coli
Pyogenic organism
Cl.tetani

13. CLINICAL MANIFESTATION
Serous or seropurulent umbilical discharge
Offensive
Base of the cord look moist
Periumbilical skin red and moist
Delay in falling off of the cord

14. SPREAD OF INFECTION Periumbilical cellulitis with suppuration
Thrombophlebitis of the umbilical vein
Peritonitis
Necrotising fascitis

15. PREVENTION
Antiseptic and aseptic precaution right from the time of cutting the cord

16. TREATMENT
ANTIBIOTIC THERAPY
Nafcillin
Gentamicin or
Oxacillin

17. TETANUS NEONATRUM DEFINITION
Infection caused by Cl.tetani and the portal of entry through the umbilical cord
Features are evident within 5 – 15 days after birth
CLINICAL FEATURE
Inability to suck associated with marked trismus
Rigidity of the body with opisthotonus, pyrexia and convulsion

18. TETANUS NEONATRUM PREVENTION
Immunisation of the mother during pregnancy with TT
Babies born in unhygienic conditions without previous immunisation of the mother should be given1500 IU ATS IM soon after birth

19. TETANUS NEONATRUM TREATMENT Isolation
Tetanus immunoglobulin 6000 IU IM
ATS 5000 – units IM/IV same dose repeated after 12 hours
Sedation
Endotracheal intubation
Nutrition

20. NECROTISING ENTEROCOLITIS
This is a life threatening condition associated with serious vascular and mucosal injury of the relatively immature intestine

21. RISK FACTORS Premature infants Perinatal asphyxia Hypotension
Polycythemia
Umbilical cord catheter related thromboembolism
Septicemia
Exchange transfusion

22. PATHOPHYSIOLOGY
Ischemia and/or toxic damage to the mucous membrane of the gut
Ischemic necrosis of the muscular wall of the gut
Perforation and peritonitis

23. CLINICAL FEATURES SYSTEMIC SIGNS Respiratory distress Lethargy
Feeding intolerance
Hypertension
Acidosis
Oliguria
Bleeding

24. CLINICAL FEATURES ABDOMINAL SIGNS Abdominal distension Tenderness
Bloody stools
Vomiting

25. DIAGNOSIS X-Ray abdomen – gas pattern with dialated loops Bloody stool
Thrombocytopenia
Metabolic acidosis
Hyponatremia

26. TREATMENT
RESPIRATORY SUPPORT
NUTRITION
ANTIBIOTIC
BOWEL RESECTION

27. MUCOCUTANEOUS CANDIDIASIS
ORAL THRUSH Infection of the buccal mucous membrane and the tongue by the fungus candida albicans

28. CLINICAL FEATURES Milky white elevated patches Refuses to take feed
Attempt to remove the patch may leave a raw oozing surface
Spots on the edge of the tongue

29. TREATMENT
PREVENTION
Treat maternal fungal infections in the vagina before delivery
TREATMENT
1% gentian violet
Nystatin oral suspension
Fluconazole
Concurrent treatment of mother and baby

30. TREATMENT TREATMENT DIAPER CANDIDIASIS 2% Nystatin ointment
2% Miconazole ointment
1% Clotrimazole ointment