Approach to jaundice (newborn and infant) Quiz: Ace Your Exams
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An 11-month-old infant boy is brought to the office by his parents for jaundice. Parents report they introduced multiple new foods recently. The parents noticed two days ago that he looked yellow. Additionally, he has been more fussy than usual, and his activity level has decreased. The urine is dark-colored, and there is no change in stools. He has not had fever, vomiting, seizures, or hypotonia. Pregnancy, birth, medical, and surgical histories are non-contributory. The parents are originally from Bahrain. Temperature is 37° C (98.6° F), pulse is 55/min, respirations are 38/min, blood pressure is 94/52 mm Hg, and oxygen saturation is 97% on room air. On physical exam, scleral icterus and facial jaundice are noted. There is conjunctival pallor. Cardiac exam is significant for tachycardia and a flow murmur. Pulmonary and abdominal exams are normal. Lab work is significant for unconjugated hyperbilirubinemia and anemia. The peripheral blood smear is shown below. Which of the following should be performed next to confirm the diagnosis?
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