Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical signs of neonatal sepsis that healthcare professionals should be vigilant for include:
- Red flag signs: apnoea (temporary stopping of breathing), seizures, need for cardiopulmonary resuscitation, need for mechanical ventilation, and signs of shock NICE NG195.
- Altered behaviour or responsiveness, such as appearing ill, not waking or not staying awake when roused, weak high-pitched or continuous cry NICE NG195,NICE NG194.
- Altered muscle tone, for example, floppiness NICE NG195.
- Feeding difficulties including feed refusal, feed intolerance, vomiting, excessive gastric aspirates, and abdominal distension NICE NG195.
- Abnormal heart rate: bradycardia or tachycardia NICE NG195.
- Signs of respiratory distress such as grunting, chest recession, tachypnoea, nasal flaring, and hypoxia (central cyanosis or reduced oxygen saturation) NICE NG195,NICE NG194,NICE NG51.
- Temperature abnormalities: hypothermia (below 36°C) or fever (above 38°C) unexplained by environmental factors NICE NG195,NICE NG194.
- Jaundice within 24 hours of birth NICE NG195.
- Signs of neonatal encephalopathy and bulging fontanelle NICE NG195,NICE NG194.
- Unexplained excessive bleeding, thrombocytopenia, or abnormal coagulation NICE NG195.
- Altered glucose homeostasis (hypoglycaemia or hyperglycaemia) and metabolic acidosis NICE NG195.
- Skin changes such as mottled or ashen appearance, cyanosis of skin, lips or tongue, and non-blanching rash NICE NG194,NICE NG51.
- Other signs include persistent pulmonary hypertension of the newborn and seizures NICE NG195,NICE NG194.
Healthcare professionals should consider these signs collectively, especially the presence of any red flags or multiple clinical indicators, to promptly identify and manage neonatal sepsis NICE NG195,NICE NG194.