Value of chest radiography screening in neonatal sepsis

ABSTRACT

Neonatal sepsis has nonspecific clinical presentation including temperature variation, respiratory complaints, jaundice, poor feeding and central nervous system [CNS] abnormalities. Chest X-ray [CXR] is performed frequently in the initial work-up even if there are no respiratory symptoms or signs. The value of inclusion of chest radiography as part of routine initial investigation in suspected neonatal sepsis cases This was a retrospective study which included review of medical records of 69 neonates with suspected neonatal sepsis. These neonates were assessed clinically, had undergone diagnostic work-up and screening tests which included clinical laboratory, microbiology, immunology and radiological investigations. Out of the 69 neonates, 38 [55.1%] were males and 31 [44.9%] females. On clinical assessment, 24 [34.7%] had respiratory symptoms, whereas only 9 [13%] had significant respiratory signs. Only 52 [75.3%] neonates out of 69 had chest X-ray performed as part of the initial screening. Only 7 [35] neonates presented with respiratory symptoms and an abnormal chest X-ray findings, while 1 [3.1%] neonate without respiratory symptoms had an abnormal X-ray findings [P = 0.003]. Additionally, 6 [66.7%] neonates who had respiratory signs showed abnormal X-ray findings and 2 [4.7%] neonates who did not have respiratory signs had abnormal chest X-ray [P <0.001]. Chest x-ray should be carried out in the initial screening for neonatal sepsis only if there is/are significant respiratory manifestation[s] especially, if respiratory sign[s] is/are present, or highly indicated to exclude other differential diagnosis