Vol. 5, Issue 11 (2019)
Evaluation and Role of Basic Hematological Scoring System in Early detection of Neonatal Sepsis
Author(s): Dr. K N Mishra, Dr. Randhir Kumar Mishra
Abstract: Neonatal sepsis has subtle and varied clinical presentation in the initial stages. Aggressive approach to diagnosis and management is the principle determinant of the prognosis. Early diagnosis of neonatal sepsis is the corner stone to reduce the case fatality rate. Blood culture to identify the organism is the gold standard for the diagnosis. However, the yield is low due to several reasons such as low inoculum in the sample sent, inability of the laboratory to identify all the organisms and prior antibiotic usage.1 Added to this is the delay in obtaining the results. The earliest result will be available after 48 hours of incubation of the blood sample. This period could be too late for the clinician to initiate any useful treatment. The present study was done in SNCU of Department of Pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India. Total 50 neonates having positive indications for the sepsis were included in the present study. Score of ≤ 2 is considered as lower risk; score 3‑4 as moderate risk; and score ≥ 5 as higher risk for developing sepsis. Minimum score that can be obtained is 0 and maximum score up to 7. Neonatal sepsis is a life-threatening yet treatable condition. Non- infectious disorders may produce haematological changes similar to those seen with infection, thereby compromising the specificity and positive predictive value of the screening tests. The feasibility and the cost effectiveness of Haematological scoring system increase the usefulness of this test. Modified haematological score improves the specificity and likelihood ratios without decreasing the sensitivity in neonatal sepsis. Hence it can be concluded that the hematologic scoring system are useful test to distinguish the infected from non-infected infants. These are simple, quick, cost effective and readily available tool with high sensitivity and specificity in the early diagnosis of neonatal sepsis.
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