Effect of the use of hydrocortisone on the WBC count in follow up of neonatal sepsis

Abstract

Neonatal sepsis is a clinical syndrome characterized by many signs and symptoms which are non specific for diagnosis. Blood culture is standard measure but needs time to give it's results. Monocyte count is now used for early detection and follow up of patients of neonatal sepsis. Hydrocortisone therapy in neonatal sepsis is still controversial for many years as clarified by many studies. The aim of the study is to evaluate the role of hydrocortisone therapy on the WBC count in the follow up of patient with neonatal sepsis. The number of studied cases were 46 neonates diagnosed as a cases of neonatal sepsis after positive blood culture. Each one was assessed clinically by prepared questionnaire including history and clinical assessment. WBC count was done before hydrocortisone therapy for all included cases. The included cases were divided into two groups ,one group were given hydrocortisone and the other group were treated without hydrocortisone. Eight babies were died during the first week of the therapy and 38 cases were followed up after 1wk.by the same parameter that mentioned above. Very early neonatal sepsis was the commonest clinical type of sepsis 30(65,2%) with poor feeding is the common presentation 40(87%).Group B. streptococcus was the commonest bacteria isolated in 17 cases (37%).Before the hydrocortisone therapy WBC count was high in 28(60,9%). After 1 week of hydrocortisone therapy WBC count was abnormal in 4 cases (22,2%) in the group 1(with hydrocortisone therapy) while in patients with group 2(without hydrocortisone therapy) abnormal WBC count was(0) respectively. The WBC count is not a good predictor test for diagnosis and follow up in non hydrocortisone using cases.