The Diagnostic Value of Hyperthermia In Neonatal Sepsis

Abstract

Background and aim: In this study, we aimed to evaluate the prevalence of hyperthermia in the setting of a tertiary care neonatal intensive care unit (NICU) and to determine its relationship with early onset sepsis (EOS) and late onset sepsis (LOS) among newborns presenting with temperature symptoms.

Methods: In this cross-sectional  study set in Pediatric Hospital Damascus Medical College, during 12 months (since Jan. 2013 till Dec. 2013); we included all newborns in the first 28 days after birth, hyperthermia (> 38 °C).

Results: Among 5140 newborns, 2519 newborns were treated for sepsis and 747(14.5% of all presented newborns) of them had hyperthermia, 126 of them were excluded. Statistically the fever had low sensitivity especially in preterm infants (14.21%) compared to (24.6%) in term infants, whereas the specificity was high and equal in both two groups (92.8%). On the other hand the Positive predictive values (PPV) were Similar (74.4% vs. 72.6%). Whereas the Negative predictive values (NPV) were (42.3% vs. 61.6%). Regarding the sepsis early onset sepsis (EOS). It had lower sensitivity than late onset sepsis (LOS) (20% vs. 50%), and the prevalence of the fever is inversely proportionate with the sepsis severity especially in EOS with p-value 0.00015 < 0.05.

Conclusion: hyperthermia was relatively a common symptom in our NICU with a prevalence of 14.5%. Fever had almost high identical specificity for both term and preterm infants compared to relatively low sensitivity value. With a higher sensitivity value in (LOS) than in (EOS). The incidence of fever is inversely proportionate with the sepsis severity especially in EOS.