Neonatal Sepsis in the Emergency Department

Despite significant improvements in the care and management of acutely ill infants, septicemia remains one of the top 10 causes of neonatal death. Neonates can present either shortly after birth or later with subtle signs to suggest infection. Early diagnosis and prompt intervention are essential to prevent serious morbidity and mortality in neonates (<28 days of age) and infants (>28 days of age) with sepsis. Unlike older children, a young infant is often incapable of demonstrating clinical evidence of illness, and even a "well-appearing" infant may have a bacterial or viral disease. The immaturity of the newborn's immune system may increase the susceptibility of these patients to infections. The following article is a review of the clinical presentation, differential diagnosis, and evaluation and management of a neonate presenting to the emergency department with suspected sepsis.