Approach to primary immunodeficiencies Quiz: Ace Your Exams
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A 1-month-old infant presents with delayed cord separation. Pregnancy and delivery were uneventful. Past medical history is significant for two episodes of otitis media. The patient has no rash, vomiting, or diarrhea. Temperature is 38.4°C (101.1°F), pulse is 190/min, respirations are 33/min, blood pressure is 75/40 mm Hg, and oxygen saturation is 97% on room air. On physical examination, the umbilical cord appears attached with an erythematous and tense umbilical stump. A complete blood cell count (CBC) is shown below. Immunoglobulin levels are normal. Which of the following is the most appropriate next step in management?
| Laboratory value | Result |
| Complete blood count (CBC) | |
| Hemoglobin | 16 g/dL |
| Hematocrit | 45 % |
| Leukocyte count | 59,100 /mm3 |
| Platelet count | 400,000/mm3 |
| Neutrophils | 78% |
| Eosinophils | 0% |
| Basophils | 0% |
| Lymphocytes | 20% |
| Monocytes | 2% |
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