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This study identified distinct clinical courses of infant septicemia, differentiating acute and tardy presentations. Specific laboratory and immunological markers aid in diagnosing these severe infections in newborns.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Immunology
- Clinical Microbiology
Context:
- Septicemia is a critical concern in infants during their first year of life.
- Understanding distinct clinical courses and diagnostic markers is crucial for timely intervention.
- This retrospective study analyzed 27 infant cases from 1976-1982.
Purpose:
- To investigate the clinical manifestations and progression of septicemia in infants.
- To identify characteristic laboratory (hematological, biochemical) and immunological findings for specific septicemia types.
- To establish diagnostic criteria for differentiating septicemia subtypes.
Summary:
- Three main clinical courses were identified: acute septicemia with shock (Septic-Toxic-Course, STC), tardy septicemia with single-organ involvement (Meningoencephalitis, Osteomyelitis, Phlegmon), and tardy septicemia with multi-organ spread (septicopyemia).
- STC and septicopyemia presented with systemic signs of bacterial dissemination.
- Tardy septicemia with single-organ involvement showed symptoms localized to the affected organ.
- Elevated liver enzymes (GOT, GPT, LDH) were a key diagnostic marker for STC.
- Humoral and/or cellular immunodeficiency was noted in tardy septicemia, suggesting a therapeutic target for broad-spectrum antibody administration.
Impact:
- Provides a framework for classifying infant septicemia based on clinical course and diagnostic markers.
- Highlights the diagnostic utility of liver enzyme elevation in acute septicemia.
- Identifies immunodeficiency as a factor in tardy septicemia, guiding potential therapeutic strategies.
Abstract:
In a retrospective study it was investigated in which a course the septicemia appears during the first year of life and which laborchemical and immunological findings are typical for the specific manifestation and can be used for the diagnosis. 27 sucklings with septicemia were admitted at our hospital during 1976-1982. As the clinical course we found: the acute septicemia with pronounced shocksymptoms (Septic-Toxic-Course, STC), the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem, namely in the brain (Meningoencephalitis), in the bone (Osteomyelitis) and in the soft tissue (Phlegmon), the septicemia with a tardy course and forms a septicopyemia with secundary dispersion of bacteria in multiple organsystems. Only STC and septicopyemia show the symptoms which are lead back with the dispersion of bacteria. By the septicemia with a tardy course and hematogenous dispersion of bacteria in one organsystem the clinical symptoms are determined only in the infected organ. As the only course of septicemia the STZ shows laborchemically in the blood a damage to the livercells with a constant elevated levels of plasmaencyms GOT, GPT and LDH; this findings can be used for a diagnostic criterion. By septicopyemia, meningitis and osteomyelitis the findings of sepsis exist in the blood but are rare by phlegmon. By septicemia with a tardy course (2, 3) a humoral and/or cellular immundeficiency exist. This is a point of application for therapy to give biological antibody with a large spectrum.