Pneumonia in the baby after birth
Pneumonia in babies can also occur immediately after birth. This is a so-called newborn infection, which has various causes. In the context of an amniotic infection syndrome, the baby can be infected with germs already in the mother’s uterus.
The pathogens usually ascend from the mother’s vagina into the uterus and cause an infection there. When the baby is born, symptoms such as fever, apathy, unwillingness to drink, breathing difficulties and circulatory problems can occur within the first 72 hours of life. In most cases, these are bacteria known as group B streptococci.
In principle, any organ can be affected by such an infection, but pneumonia is common. In any case, immediate intensive medical care of the baby and an immediate therapy with antibiotics is carried out, as otherwise there can be serious, life-threatening consequences. Even after the first 72 hours of life, an infection can develop, resulting in pneumonia.
There are many risk factors that promote such pneumonia, such as complications at birth, wounds on the child, medical measures such as the insertion of catheters or accesses to the blood system and much more. The diagnosis of pneumonia in babies and infants can be very difficult. The age of the child, the geographical location of the site of infection and the time of year must be taken into account when identifying the pathogen.
The examination of a blood culture is the method of choice for adults, but often does not lead to a positive result in small children. The blood can still be checked for its inflammatory parameters and leukocyte count. Although this provides evidence of an infection, it does not tell us where the infection is located.
Finally, a PCR, a polymerase chain reaction, can be performed to identify the pathogen. In this process, specific components of the pathogen genome are amplified and then detected. Sputum, i.e. a sample of the mucus that is ejected, is difficult to obtain from babies, as they are not yet able to react arbitrarily to instructions.
Other methods used in older patients are too dangerous for babies and do not achieve a satisfactory risk-benefit ratio. This also eliminates the need for bronchoalveolar lavage (taking fluid from the alveoli) or pulmonary puncture (using a long needle to take fluid from the outside of the lungs). While a smear of the nasopharyngeal secretion (smear of the secretion of the pharyngeal mucosa) is already useless in schoolchildren, it is excellent in infants for obtaining information about the pathogen.
Often pneumonia in babies is caused by a superinfection of the respiratory system. The viruses first settle in the patient’s throat and then, due to a deficient immune system, migrate down into the lower parts of the lungs. Due to the radiation exposure, imaging procedures are not used as a first diagnostic measure.If the patient shows no reaction to an existing antibiotic therapy, if the course of the disease is atypical or particularly severe, an X-ray of the thorax (chest) is usually taken as part of damage control.
The bronchopneumonia typical of infants and small children is shown in the picture as a completely brightened change. This is due to the infiltrate which is located in the lung tissue and makes it additionally impermeable to X-rays. A lobar pneumonia, which is rare in babies, is limited to one lobe, which is shown in the image as a sharply limited brightening.
The benefit of X-ray diagnostics is controversial. The child is exposed to the radiation and the picture often does not give any indication of the pathogen. Shadowing in the image may confirm the suspicion, but can also be misinterpreted.
Thus the rate of uselessly prescribed antibiotics increases. An alternative to X-rays is lung sonography – the ultrasound examination of the lungs. This allows superficial inflammation foci to be identified more specifically as such and also pleural effusions, which occur in the context of a pneumonia with pleural involvement (pleura = pleura = pleura), are more easily detected. However, sonography is clearly inferior to X-rays when it comes to deeper-seated inflammation.
