Neonatal sepsis



Neonatal sepsis



Neonatal sepsis


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USMLE® Step 1 questions

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Neonatal sepsis

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USMLE® Step 1 style questions USMLE

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A 2-day-old boy is brought to the emergency department due to fever and poor feeding. The child was born to a gravida 0 para 1 woman. He was born at home via normal vaginal delivery. The mother did not participate in routine prenatal visits and opted to give birth at home with assistance from a midwife. Temperature is 39.0°C (102.2°F), heart rate is 200/min, blood pressure is 60/40 mmHg, and respiratory rate is 44/min. On physical examination, the child appears irritable and lethargic. The lungs, heart, and abdomen are clear on examination.  Blood workup reveals leukocytosis and elevated C-reactive protein. Bacterial cultures of the blood are positive for a Gram-positive ꞵ-hemolytic cocci. Which of the following interventions could have prevented this complication in this patient?


Neonatal sepsis is a serious condition in which bacteria and other germs enter the body and cause an infection in a neonate's bloodstream, in the setting of fever. Neonatal sepsis has two categories: early-onset sepsis (EOS) and late-onset sepsis (LOS). EOS refers to sepsis presenting in the first 3 days of life. EOS is usually caused by Group B Streptococci or Escherichia coli, usually presenting itself as pneumonia. On the other hand, LOS presents itself after 3 days. LOS is usually caused by Staphylococcus and commonly manifests itself as meningitis.

Symptoms of neonatal sepsis may depend on the category, but they commonly include fever, irritability, difficulty feeding, and a poor overall appearance. In severe cases, neonatal sepsis can lead to organ failure and death.

Treatment for neonatal sepsis typically involves antibiotics to kill the bacteria causing the infection and supportive care, such as intravenous fluids, respiratory support, and medications to control symptoms like fever.


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