Diagnostic value of clinical signs in neonatal sepsis

History and Sepsis is one of the most serious diseases in neonates that is as a result of hemodynamic and metabolic disturbances following infection. The major criterion for its diagnosis is to cultivate the sterile fluids of the body including blood, cerebrospinal fluid and urine. Meanwhile, its result is prepared with delay. Until now, there has not been any report on the diagnostic value of clinical signs in Iran. Therefore, this study was performed on neonates referred to Shaheed Beheshti and Shabihkhani hospital during the years 1999-2000. The clinical trial and diagnostic strategy of this study was carried out on 120 neonates. In this respect, the suspected cases for sepsis were admitted and clinical signs including convulsion, fever, vomiting, anorexia, hypothermia, cyanosis, respiratory distress and hyporeflexia were evaluated. In addition, specimens of CSF, blood and urine were analyzed. Then, the diagnostic value of each one of these signs was determined. The most common observed signs were hyporeflexia and anorexia. In 13% of them (10.8%), there was a positive result for culture of each one of the sterile fluids. In addition, the predictive value specificity was the highest for convulsion and the most sensitive sign was anorexia. All of the cases (n=111) with positive culture were treated and cured using antibiotics and complementary treatments. The results showed diagnostic value of clinical signs in neonatal sepsis is limited. Furthermore, considering a recovery of 92.5% for cases, it could be concluded that positive culture is a golden standard for definite diagnosis of neonatal sepsis.