Hooven Thomas A, Polin Richard A
Columbia University, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Columbia University, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA.
Semin Fetal Neonatal Med. 2017 Aug;22(4):206-213. doi: 10.1016/j.siny.2017.03.002. Epub 2017 Mar 24.
Neonatal pneumonia may occur in isolation or as one component of a larger infectious process. Bacteria, viruses, fungi, and parasites are all potential causes of neonatal pneumonia, and may be transmitted vertically from the mother or acquired from the postnatal environment. The patient's age at the time of disease onset may help narrow the differential diagnosis, as different pathogens are associated with congenital, early-onset, and late-onset pneumonia. Supportive care and rationally selected antimicrobial therapy are the mainstays of treatment for neonatal pneumonia. The challenges involved in microbiological testing of the lower airways may prevent definitive identification of a causative organism. In this case, secondary data must guide selection of empiric therapy, and the response to treatment must be closely monitored.
新生儿肺炎可能单独发生，也可能是更广泛感染过程的一部分。细菌、病毒、真菌和寄生虫都是新生儿肺炎的潜在病因，可通过母婴垂直传播或从出生后的环境中获得。发病时患者的年龄有助于缩小鉴别诊断范围，因为不同病原体与先天性、早发型和晚发型肺炎相关。支持性护理和合理选择抗菌治疗是新生儿肺炎治疗的主要方法。下呼吸道微生物检测面临的挑战可能会阻碍对病原体的确切鉴定。在这种情况下，必须依据二级数据指导经验性治疗的选择，并且要密切监测治疗反应。
