Fanaroff et al evaluated low birthweight infants for late onset sepsis. They identified features which can help to identify an infant who may benefit from more aggressive management. The authors are from Case Western Reserve University, the University of Tennessee, and multiple other universities in the United States.


Patient selection: infant weighing 501 to 1,500 grams


Late onset sepsis was not defined but appears to be 4 or more days after delivery (>= 96 hours), up to 120 days.


Risk factors for late onset sepsis:

(1) male gender

(2) lower gestational age (born more prematurely)

(3) very low birthweight

(4) low serum IgG concentration


Findings suggesting late onset sepsis:

(1) apnea

(2) feeding intolerance

(3) abdominal distention

(4) guaiac-positive stools

(5) lethargy

(6) hypotonia

(7) need for respiratory support

(8) unexplained metabolic acidosis

(9) hyperglycemia

(10) abnormal white blood cell count (leukopenia, leukocytosis, or left shift)

(11) hypotension (10 mm Hg drop in systolic and/or diastolic blood pressure)


To read more or access our algorithms and calculators, please log in or register.