Hypothermia, Poor feeding,
Sclerema, Mottling, Lethargy.
A provisional diagnosis of early onset neonatal sepsis (EONS) with diffuse sclerema was made.
The child did not respond properly to the abovementioned treatment during the first 48 hours of admission; rather, sclerema progressed further.
It may be used with caution in neonatal sepsis associated with neutropenia,
sclerema, earliest evidence of disseminated intravascular coagulation and metabolic acidosis (pH <7.2).
Only one case of breast abscess was seen and it appeared on the 7th day, while one case of
sclerema neonatorum was seen on 2nd day.
d)
Sclerema neonatorum regarded as end stage of severe systemic disease, is an uncommon, life-threatening condition, usually of newborns, with a case-fatality rate ranging from 50 to 100 Percent .
Neonatal hypothermia needs to be immediately identified and effectively managed since it can lead to a wide range of complications including "seizures, infection, hypoglycaemia, cardiac dysrrhythmias, gastrointestinal bleeding,
sclerema, hypovolaemia, metabolic acidosis, jaundice, respiratory distress, pulmonary hemorrhage and death."18 Curtailing heat losses improves the long term outcome and longevity in preterm and low birth weight babies.10
Clinically it mimicked closely with birth trauma, giant congenital melanocytic nevus, congenital developmental anomaly, incontinentia pigmenti and
sclerema neonatorum.
Inclusion Criteria: Clinically suspected cases of neonatal sepsis with signs and symptoms suggestive of sepsis such as refusal to feed, feeding intolerance, lethargy, excess irritability, high pitched cry, seizures, temperature instability, apnea, respiratory distress, poor perfusion, tachypnea, bradycardia, abdominal distension, necrotizing enterocolitis, vomiting,
sclerema were included.
Thirty septicemic neonates who were critically ill (
Sclerema), underwent exchange transfusion.