4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
A neonate on day 3 presents with dullness. On examination we found the vitals are stable, crying, sucking, activity and neonatal reflexes are not satisfactory. IV antibiotics , iv fluids are started and CBC, CRP done. Vitamin K is also given. Hb is 10.3g/dl, TLC is 2 lacs/mm3 with normal platelets. 40%normoblasts are seen and there are no atypical WBCs seen.(Blood reports checked thrice by different laboratories).The baby showed improvement initially but on day 5 he had massive hemetemesis and the child was in impending hemorrhagic shock which was managed by FFPs and packed red cells. What is the further line of investigations & management and what is the differential diagnosis?
Answer
Rule out neonatal leukemia since the counts are more than 2lacs. Also what is the PT and PTT for the child to have hematemesis? Any organomegaly? More clinical details are needed. A bone marrow examination may be essential.
 
 
 
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Today's Poll
Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
No, it should be used only after drug sensitivity report
Yes, under guidance of an infectious disease expert
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