robin082006
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A 7-day-old female neonate is brought to your office for a 2-day history of jaundice and poor feeding. The mother also says that she has vomited twice but she doesn’t appear febrile. She is breast-feeding her baby regularly. The baby’s birth history is unremarkable. On examination the child appears listless, and mild jaundice along with signs of dehydration are noted. Her vitals are: BP: 78/52mm of Hg; PR: 150/min; Temperature: 36C(96F). Family history is insignificant. What is the most appropriate next step in the management of this patient?
A. Stop breast feeding
B. Obtain blood cultures and lumbar puncture
C. Obtain peripheral smear and reticulocyte count
D. Obtain liver function tests
E. Obtain Coomb’s test and osmotic fragility test
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| sarika
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i think its A. Stop breast feeding probably deficiency of galactose metabolism
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| prathapdoctor
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i will go with option B, in neonatal sepsis there may not be any fever.the child has 36 degrees temp,that means hypothermia which could be a feature of neonatal sepsis.
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| Guptashutosh
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yeah B sound s better option here
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| young_doc
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B
"...Temperature instability is observed with neonatal sepsis and meningitis, either in response to pyrogens secreted by the bacterial organisms or from sympathetic nervous system instability. The neonate is most likely to be hypothermic. The infant may also have decreased tone, lethargy, and poor feeding..."
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| young_doc
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Sorry that last post was from:
http://www.emedicine.com/ped/topic2630.htm
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