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Uniqcret EONS criteria for early-onset neonatal sepsis (EONS)


Early-Onset Neonatal Sepsis (EONS) Criteria

Definition: Sepsis occurring within the first 72 hours of life.

Maternal Risk Factors:

1. Prolonged rupture of membranes (>18 hours before delivery).

2. Maternal fever:

- ≥38°C on two separate occasions at least 1 hour apart.

- Single occurrence of fever ≥39°C.

3. Maternal urinary tract infection or chorioamnionitis.

4. Maternal Group B Streptococcus (GBS) colonization without adequate intrapartum antibiotic prophylaxis.

5. Premature delivery (especially if <37 weeks gestation).

Clinical Signs in the Neonate:

1. Respiratory distress (e.g., grunting, flaring, retractions, tachypnea).

2. Temperature instability (hypothermia or hyperthermia).

3. Feeding intolerance (e.g., vomiting, abdominal distension).

4. Lethargy or irritability.

5. Hypotonia or reduced activity.

6. Poor perfusion or circulatory collapse.

7. Apnea or bradycardia.

8. Cyanosis or pallor.

9. Tachycardia (increased heart rate).

Laboratory Findings:

1. Positive blood culture for pathogens.

2. Cerebrospinal fluid (CSF) analysis showing pleocytosis, elevated protein, and/or decreased glucose.

3. Abnormal complete blood count (CBC) with differential, such as leukocytosis, leukopenia, or increased immature-to-total neutrophil ratio (I:T ratio).

4. Elevated C-reactive protein (CRP) or procalcitonin levels.

Triple I Criteria (Intrauterine Inflammation or Infection or both):

1. Maternal fever as mentioned above.

2. Elevated maternal WBC count >15,000 cells/mm³.

3. Foul-smelling amniotic fluid.

4. Uterine tenderness.

5. Maternal tachycardia.

6. Fetal tachycardia.

Associated Infections (TORCH):

1. Toxoplasmosis

2. Other infections (e.g., syphilis, varicella-zoster, mumps, parvovirus B19)

3. Rubella

4. Cytomegalovirus (CMV)

5. Herpes simplex virus (HSV)

Clinical Presentation of TORCH Infections:

1. Growth retardation.

2. Jaundice.

3. Hepatosplenomegaly (enlarged liver and spleen).

4. Fever.

5. Skin rashes or vesicles.

6. Microcephaly (small head size).

7. Hearing loss.

8. Eye abnormalities like cataracts or chorioretinitis.

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