Fever and Hypothermia in Newborns

Abstract Fever in the neonatal period is defined as a body temperature above 38 C. Although the exact mechanisms are unknown, fever results from a dispruption of complex relations between heat production and heat loss. Many infectious or non-infectious causes may leadto fever. Most common infectious agents are viruses. Bacterial agents include E coli and other gram negative pathogens. All newborns who have fever should be admitted to the hospital and evaluated for infections even if they look well. Evaluation of procalcitonin and CRP is better in diagnosing serious bacterial infections in the first 36-72 hours of life. Leukocyte count is insufficient to diagnose an infection. In newborn infants, a body tem-perature of 36.,0 – 36,4 is known as mild hypothermia (cold stress), 32,0 – 35,9 C is known as moderate hypothermia and below 32 C is diagnosed as severe hypothermia. Risk of hypothermia is larger in preterminfants. If not treated, hypothermia may result in whole body coldness, loss of activity and suck, and weak cry. Differential diagnoses include hypoglycemia, hypothalamic and autonomic dysfunction, infections, endocrine and metabolic diseases, central nervous system depression and decreased caloric intake. A hypothermic infant should be warmed as soonas possible, but not too quickly