Intrauterine pneumonia and other types in the newborn

Intrauterine pneumonia and other types in the newborn

Congenital pneumonia is infection of the newborn’s lungs. It can affect up to 10% of premature or low birth weight newborns.
It is a serious infection in the newborn and consists of the inflammation of the lung tissue , specifically, of the alveolar sacs, due to infectious agents, such as bacteria and viruses. We can classify newborn pneumonia into:

intrauterine pneumonia

The bacteria or virus reaches the respiratory system through the mouth from the maternal genital tract. This type of pneumonia is associated with infection of the amniotic fluid due to premature rupture of the membranes or with a genital infection of the mother. These two circumstances can also occur together: genital infection and rupture of the membranes.

Differentiating an intrauterine pneumonia from a congenital one is very difficult since, clinically, they give the same symptoms and radiologically as well. It is for this reason that many authors equate the concept of congenital and intrauterine pneumonia.

congenital pneumonia

The organism is acquired transplacentally (through the placenta), that is, pulmonary infection is only a complication of a severe generalized infection. It is a serious situation in the newborn.

Pneumonia acquired during childbirth

The infectious agent reaches the lung through the oropharynx when the baby aspirates maternal secretions from the birth canal or contaminated amniotic fluid . It is related to premature rupture of membranes and fetal distress during birth.

These three pneumonias are called early-onset pneumonias because they develop during the first three days of life and in which the origin of the infection is maternal . The most frequent cause is  bacteria  (group B streptococcus, listeria and tuberculosis) but it can also be caused by some  viruses  (herpes virus) and  fungi  (Candida ).

postnatal pneumonia

The cause is external and its most frequent origin is nosocomial , that is, it is caused by germs from the hospital environment . The use of invasive procedures (venous lines or accesses, probes, respirators…) used in intensive care units are its main cause, in addition to the natural immunosuppression of the newborn and its vulnerability, which makes it prone to having serious infections.

This type of pneumonia can also be of community origin , that is, it can be caused by microbes that are in the community (outside the hospital) and whose transmission is due to contact with relatives.

It is a late-onset pneumonia , which occurs during the hospitalization of the newborn or after hospital discharge. Newborns with intravenous catheters and endotracheal tubes are at greater risk of this type of infection. Most are bacterial pneumonias, although they can also be viral or fungal . In the case of late-onset viral pneumonia, the origin of the infection is a sick family member. The most common virus is RSV (Respiratory Syncytial Virus).

 

Symptoms of pneumonia in babies

All these pneumonias of the neonatal period have similar symptoms and are serious . One of the first warning signs is:

  • respiratory distress
  • Refusal of feeding with difficulty suckling
  • Tos
  • Mucus
  • Fever 
  • bad look

Although it is a localized infection in the lung, as the newborn is immunosuppressed (they have a very immature immune system), it can spread quickly and progress very aggressively, developing an infection spread throughout the body ( sepsis ) in the first hours of life.

 Treatment

Treatment always involves hospital admission and antibiotic treatment should be started as soon as possible to avoid complications. The antibiotic will depend on the type of microorganism that grows in the cultures. If lung involvement is very severe, the newborn may need respiratory support or mechanical ventilation . Until the newborn is fully recovered, they are not discharged from the hospital.

What you should know…

  • It is a serious infection in the newborn and consists of inflammation of the lung tissue, caused by viruses or bacteria.
  • One of the first warning signs is respiratory distress and refusal to feed with difficulty sucking.
  • Treatment always involves hospital admission and antibiotic treatment should be started as soon as possible to avoid complications.
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