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Sepsis (Blood Poisoning)

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Neonatal Sepsis (Sepsis Neonatorum)

Neonatal Sepsis (Sepsis Neonatorum)

Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Neonatal sepsis is any infection involving an infant during the first 28 days of life. Neonatal sepsis is also known as "sepsis neonatorum." The infection may involve the infant globally or may be limited to just one organ (such as the lungs with pneumonia). It may be acquired prior to birth (intrauterine sepsis) or after birth (extrauterine sepsis). Viral (such as herpes, rubella[German measles]), bacterial (such as group B strep) and more rarely fungal (such as Candida) causes may be implicated.

During her pregnancy, a women's obstetrician is constantly monitoring the health of both of the pregnant women and her fetus for any signs or symptoms that might indicate sepsis. Prior to birth, many indicators can signal that a potential infection is developing. Women are screened for infectious diseases at their first OB office visit. Some of these include HIV, gonorrhea, syphilis, herpes, Chlamydia, and hepatitis B, as well as immunity to rubella  and chickenpox. Between the 35th and 37th week of pregnancy, screening for group B strep is commonly performed. Some symptoms and signs, such as slower than anticipated fetal growth, may be subtle indications of threatened fetal well-being. Measurement of uterine size via the traditional tape measure or ultrasoundexamination of the uterus, placenta, and fetus will both provide critical information. Throughout the pregnancy, office visits provide the opportunity to monitor fetal heart rate. The obstetrician commonly evaluates both the actual heart rate at rest as well as the infant's cardiac response to a mild stress(for example, uterine contraction). If concerns develop, specialized evaluations can be performed ("stress testing") during which fetal heart rate, fetal movement and fetal tone are monitored and an objective risk assessment may be made. Maternal feverduring her pregnancy warrants a timely and thorough evaluation. Equally significant would be the onset of premature labor or premature rupture of the amniotic sac (termed "premature rupture of membranes").

Sepsis (blood poisoning) facts

  • Blood poisoning is a nonmedical term that usually refers to the medical condition known as sepsis.
  • Sepsis is a potentially dangerous or life-threatening medical condition found in association with a known or suspected infection whose signs and symptoms fulfill at least two criteria of a systemic inflammatory response syndrome (SIRS).
  • The major SIRS criteria are an increased heart rate, fever, and increased respiratory rate; the young and the elderly may show other early signs and symptoms of sepsis sometimes before exhibiting SIRS criteria.
  • The majority of cases of sepsis are due to bacterial infection.
  • Sepsis is treated with hospitalization, intravenous antibiotics, and therapy to support any organ dysfunction.
  • Prevention of infections and early diagnosis and treatment of sepsis are the best ways to prevent sepsis or reduce the problems sepsis causes.
  • The prognosis depends on the severity of sepsis as well as the underlying health status of the patient; in general, the elderly have the worst prognosis.

What is blood poisoning?

Blood poisoning is a nonspecific term used mainly by nonmedical individuals that describes, in the broadest sense, any adverse medical condition(s) due to the presence of any toxic agent in the blood. Usually, the layperson using the term blood poisoning is referring to the medical condition(s) that arise when bacteria or their products (or both) reach the blood. Blood poisoning is not a medical term and does not appear in many medical dictionaries or scientific publications. However, when it is used, the correct medical term that most closely matches its intended meaning is sepsis. Many medical authors consider the terms blood poisoning and sepsis to be interchangeable, but the trend in the medical literature is to use the term sepsis.

What is sepsis?

Sepsis is a potentially dangerous or life-threatening medical condition, found in association with a known or suspected infection (usually caused by but not limited to bacteria) whose signs and symptoms fulfill at least two of the following criteria of a systemic inflammatory response syndrome (SIRS):

  • elevated heart rate (tachycardia) >90 beats per minute at rest


  • body temperature either high (>100.4F or 38C) or low (<97F or 36C)


  • increased respiratory rate of >20 breaths per minute or a reduced PaCO2 (partial pressure of carbon dioxide in arterial blood level)

  • abnormal white blood cell count (>12000 cells/µL or <4000 cells/µL or >10% bands [an immature type of white blood cell])

Patients who meet the above criteria have sepsis and are also termed septic. These criteria were proposed by several medical societies and may continue to be modified by other medical groups. For example, pediatric groups use the same four criteria listed above but modify the values for each to make the SIRS criteria for children. Other groups want to add criteria, but currently this is the most widely accepted definition.

Terms that are often used in place of sepsis are bacteremia, septicemia, and blood poisoning. However, bacteremia means the presence of bacteria in the blood; this can occur without any of the criteria listed above and should not be confused with sepsis. For example, you can brush your teeth and get bacteremia for a short time and have no SIRS criteria occur. Unfortunately, septicemia has had multiple definitions over time; it has been defined as bacteremia, blood poisoning, bacteremia leading to sepsis, sepsis, and other variations. Although septicemia appears frequently in the medical literature, a reader must be sure which definition the author is using. Some experts suggest the terms blood poisoning and septicemia not be used since they are poorly defined, but it is difficult for the medical community to disregard such terms that have been used for many decades.



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