Welcome to this month’s What’s Your Diagnosis Challenge!
Case Presentation: Seizures in Neonates: Diagnosis and Management in the Emergency Department
An EMS team brings in a 5-day-old boy with a history of a rhythmic, left-arm-shaking episode at home. The parents tell you the pregnancy was normal and the birth was a full-term, normal spontaneous vaginal delivery. The baby had been doing well until yesterday, when he started eating less and not waking up for feeds. The baby has low tone with a tense anterior fontanelle, and his temperature is 35.8?C (96.4?F). What workup is warranted at this time?
Given the hypothermia and bulging fontanelle in the 5-day-old boy, you were highly suspicious of an infectious etiology. You obtained a lumbar puncture, blood culture, urinalysis/urine culture, CBC, and BMP. You administered broad-spectrum IV antibiotics, acyclovir, and a normal saline bolus. The CBC was remarkable for leukocytosis and left shift with bandemia. You admitted the patient for presumed meningitis.
Review this issue?to find out more of the authors? recommendation.
Last Updated on July 21, 2020