fongch
Forum Elite
Topics: 71
Posts: 316
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Slightly modified (some obviously wrong option are omitted) from a NBME question.
Your EXPLANATION please
A premature 18-hour-old newborn is intubated and mechanically ventilated because of progressive respiratory distress. Labor was complicated by maternal fever and increased leukocyte count; membranes ruptured 36 hours before delivery. His blood pressure and urine output have decreased since birth. The newborn appears acutely ill, and peripheral pulses are not palpable; the skin is pale, cool, and mottled.
The liver edge is palpable 4 cm below the right costal margin. His leukocyte count is 5000/mm3, platelet count is 48,000/mm3, and partial thromboplastin time is 60 sec. An x-ray film of the chest shows diffuse,bilateral, interstitial infiltrates.
What is the most likely cause?
A) Chlamydia trachomatis
B) Group A streptococcus
C) Group B streptococcus
D) Listeria monocytogenes
E) Neisseria gonorrhoeae
F) Streptococcus pneumoniae
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| NE
Forum Guru
Topics: 53
Posts: 504
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MCC of chorioamniotitis- strep group B and GBS can be responsible for neonate's sepsis so the answer is C.
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| zhoufg
Forum Senior
Topics: 15
Posts: 112
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why B is not the choice. Mom obviously had prom. Listeria monocytogenes is also possible. please explain.
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| nihadam
Forum Junior
Topics: 12
Posts: 52
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I think it's L. Monocytogen. If she deliverd in a US hospital she shoild receive PNC or Cephalosporine for BHS, which doesn't cover L.M. so this baby is having sepsis due to L.M. what you think.
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| Justice
Forum Fanatic
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D) Listeria monocytogenes
___________________
Don't live in a town where there are no doctors
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| eckimazuro
Forum Newbie
Topics: 2
Posts: 15
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It think that it is Listeria:
Prematurity in neonatal sepsis (early-onset) is associated with infection from CMV, HSV, hepatitis B, toxoplasmosis, Mycobacterium tuberculosis, Campylobacter fetus, and Listeria species.
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| usmleck2007
Forum Newbie
Topics: 0
Posts: 3
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Listeria Monocytogenes: Listeriosis (early onset) D
Maternal(by ingestion/asymptomatic carriage in vagina)--flu-like illness, preterm labor, PROM
Infant(Transplacental/vertical transmission)--Neonatal sepsis, Respiratory distress
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| cirus
Forum Guru
Topics: 108
Posts: 740
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from what I know the most comman org at this period is Group B St, then the 2nd is Listeria..
Does anyone know how to differentiate between both???
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