(Septicemia and Meningitis in Neonates)

Neonatal septicemia or meningitis caused by Escherichia coli and other gram-negative bacilli cannot be differentiated clinically from infections caused by other infectious agents. The first signs of sepsis can be subtle and similar to signs observed in noninfectious processes. Clinical signs of septicemia include fever, temperature instability, heart rate abnormalities, grunting respirations, apnea, cyanosis, lethargy, irritability, anorexia, vomiting, jaundice, abdominal distention, and diarrhea. Meningitis can occur without overt signs suggesting central nervous system involvement. Some gram-negative bacilli, such as Citrobacter koseri, Enterobacter sakazakii , and Serratia marcescens , are associated with brain abscesses in infants with meningitis caused by these organisms.