PEDIATRICS Vol. 64 No. 1 July 1979, pp. 60-64
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Diagnosis of Neonatal Bacterial Infection: Hematologic and Pathologic Findings in Fatal and Nonfatal Cases

Edward Squire MD1, Blaise Favara MD1, and James Todd MD1

1 Departments of Pathology and Pediatrics, The Children's Hospital; Department of Pediatrics, Fitzsimons Army Medical Center; and Department of Pediatrics, University of Colorado Medical Center; Denver

Consecutive newborn autopsy cases were divided into infected and noninfected groups on the basis of pathologic findings and cultures, and were compared to a concomitant consecutive group of neonatal survivors with proven bacterial sepsis. Newborns dying with bacterial infection often demonstrated leukopenia, neutropenia, and thrombocytopenia, usually associated with normal bone marrow cell production. Those with nonfatal sepsis frequently had neutrophiia with an increase in absolute band counts. Of infected newborns 80% showed one or more hematologic abnormalities as did 43% of newborns dying without bacterial infection. Of newborns dying with bacterial infection 13% had no hematologic abnormality. Blood cultures were negative in 18% (seven) of the infants dying with bacterial infection. Abnormalities of the white blood cell, differential and platelet counts are not invariably specific for bacterial infection nor do normal values adequately exclude it. Blood cultures may be negative in newborns dying with significant foci of bacterial infection.

Submitted on August 14, 1978
Accepted on October 30, 1978




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