Abstract:
Background: Neonatal jaundice is a common clinical condition characterized by yellow discoloration of the skin and sclera due to hyperbilirubinemia. While physiological jaundice accounts for the majority of cases, infectious etiologies can lead to pathological jaundice with potentially serious consequences. Identifying infection-related jaundice in neonates is crucial for timely intervention and prevention of complications. We reviewed the types of infections that cause neonatal jaundice, discussed their pathophysiology, and highlighted management strategies.
Methods: This structured review is based on current literature sourced from PubMed, Scopus, and relevant clinical guidelines. Key neonatal infections associated with jaundice were analyzed, including bacterial, viral, and parasitic etiologies.
Results: Neonatal infections contribute significantly to early and late-onset pathological jaundice. Common bacterial causes include Escherichia coli, Klebsiella pneumoniae, and Listeria monocytogenes, which often present with sepsis-associated cholestasis. Listeria may be transmitted congenitally. Viral infections like Cytomegalovirus (CMV), Hepatitis B and C viruses, Rubella, and Herpes simplex virus are implicated in intrahepatic cholestasis and hepatocellular dysfunction. Parasitic infections like congenital Toxoplasmosis may also produce hepatosplenomegaly and conjugated hyperbilirubinemia. These infections impair bilirubin metabolism through hepatocellular injury, hemolysis, or biliary obstruction. Early recognition via clinical signs, laboratory evaluation (including direct and indirect bilirubin levels), and pathogen-specific tests is critical. Hyperbilirubinemia may be the only manifestation of UTI in the neonatal period. Thus extrahepatic infections in neonates may also present with jaundice.
Conclusion: Neonatal infections are important but frequently underrecognized causes of jaundice. A high index of suspicion is warranted, especially in cases of prolonged, atypical, or conjugated hyperbilirubinemia. Prompt diagnosis and appropriate antimicrobial or antiviral therapy improves outcomes and reduces the risk of long-term hepatic or neurological damage.
