Background: Neonatal sepsis is one of the important causes of neonatal morbidity and mortality particularly in the developing countries. Accurate and quick diagnosis is difficult because clinical presentation is non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. PCT is often reported to be more superior to CRP, being more sensitive and specific, starts to rise earlier and returns to normal concentration more rapidly than CRP.Methods: It is a hospital based prospective observational study. Blood samples were obtained and analyzed for blood culture, septic screen including serum CRP and PCT. Neonates were categorized into Proven Sepsis (n=39), Probable Sepsis (n=21) and Clinical Sepsis (n=40) groups on the basis of laboratory findings and risk factors. Data was analyzed by using standard statistical tests using SPSS 16.Results: Out of 100 cases, elevated PCT level >0.5 ng/dl was detected in 75 and >2 ng/dl was detected in 51 whereas CRP was positive only in 61 cases. Among the 39 culture positive cases, elevated serum PCT level was noticed in 39 (100%) cases whereas CRP level was noticed in 30 (76.9%) cases. Mean PCT levels were significantly high according to infection severity (P<0.01). Procalcitonin (Sensitivity 87.2%, Specificity 72.13%, positive predictive value 66.7% and negative predictive value 89.8% and with p value of <0.001) is more superior than CRP to predict sepsis in neonate. The mean duration of antibiotic therapy was 12.46±4.62 days in definite sepsis, 4.53±1.78 days in probable sepsis group and in clinical sepsis group 3.75±1.33 days by serial PCT measurement.Conclusions: Serum PCT levels >2 ng/dl has got a better sensitivity and NPV, which help us not only in the early diagnosis but also in the prognosis and duration of antibiotic therapy.

Neonatal endocarditis is a rare but usually fatal disease. Fungal endocarditis is an uncommon complication of invasive fungal infections and is associated with a high burden of morbidity and mortality. It frequently occurs in premature infants. The majority of these infections are caused by Candida (60-70%) and Aspergillus species (20-25%). The diagnosis is difficult because the criteria that have suggested and used in adults are not readily applicable for neonates. The incidence of fungal endocarditis in a neonate is on the rise, reported in the last decade secondary to use of central venous lines, frequent use of broad-spectrum antibiotics and neonatal surgical interventions.

Myiasis is infestation by fly larvae (diptera) in live vertebrates, including humans. Newborn period is very unusual for any infestation. In literature there are only a few cases reported of neonatal aural myiasis from India. We described a case of aural myiasis caused by the Sarcophagidae family in a 13 hours old newborn in this paper. Aural myiasis in a newborn can be dangerous because of the fatality risk due to penetration to the brain.