Neonatal pneumonia refers to inflammatory changes of the respiratory system caused by neonatal infection.
It is one of the leading causes of significant morbidity and mortality in developing countries. Neonatal pneumonia accounts for 10% of global child mortality. At the time of writing is thought to account for 750,000 to 1.2 million neonates death annually 5.
Neutropaenia with temperature instability. Symptoms include tachypnea, chest recession, and cough (absent in ⅔ of the cases) 7
Occurs with a transplacental spread. Aspiration of infected amniotic fluid after prolonged rupture of membranes or during delivery.
Maternal systemic infection:
Most commonly isolated bacteria include:
- Streptococci (group A and B)
- Staphylococcus aureus
- E. Coli
Exposure to these organisms occurs in the following cases:
- rupture of membranes more than 6 hours before delivery
- prolonged and complicated labours
- premature infants
- occurs in the first week of life and as an intrauterine pneumonia
- often caused by gram negative bacteria
- occurs in subsequent three weeks
- often caused by gram positive bacteria
Broad and wide spectrum of abnormalities varying from a normal chest, localised or diffuse alveolar densities, interstitial lung disease and features similar to hyaline membrane disease.
The most frequent and characteristic alveolar pattern is dense bilateral air space filling process with numerous air bronchograms.
Treatment and prognosis
Management usually comprises of a similar strategy to neonatal sepsis with antimicrobial therapy. The risk of mortality is heavily reliant on birth weight and age of onset; low birth weight 8 and early onset 6,7 being associated with more fatality.
hyaline membrane disease
- granular densities with air bronchograms
- usually does not have associated pleural effusion
transient tachypnea of the newborn (TTN)
- serial X-rays help differentiate TTN from pneumonia as pneumonia would persist beyond 1-2 days which is the usual duration of TTN
- neonatal lines and tubes
- neonatal respiratory distress (causes)
- neonatal chest x-ray (an approach)
- neonatal chest pathology
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- 5. Bale, Judith R., Barbara J. Stoll, and Adetokunbo O. Lucas. "Reducing Neonatal Mortality and Morbidity." (2003). Pubmed citation
- 6. Shakunthala, S. K., Rao G. Mallikarjuna, and S. Urmila. "" Diagnostic lung puncture aspiration in acute pneumonia of newborn"." Indian pediatrics15.1 (1978): 39-44.
- 7. Webber, S., et al. "Neonatal pneumonia." Archives of disease in childhood 65.2 (1990): 207-211. Pubmed citation
- 8. Lehmann, D. and P. Heywood. "Effect of birthweight on pneumonia-specific and total mortality among infants in the highlands of Papua New Guinea." Papua New Guinea Medical Journal 39 (1996): 274-283. Pubmed citation