Infectious Disease- Febrile Neonate

Portable Peds

Today we’ll be covering Febrile Neonate Diagnosis and Management, going along with this month’s theme, Infectious Disease- CNS Infections.

If you haven’t listened to our podcast before, each week we have a case-based discussion about a medical topic to help you study for the pediatric medicine board exam. Episodes are released every weekend, and the case is then reviewed and reinforced on social media throughout the week.

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Today’s Case:

A 9 day old male, born at 36 weeks gestation via normal spontaneous vaginal delivery presents to a pediatric emergency room due to increased fussiness, fever, and decreased oral intake. Maternal perinatal history is unremarkable aside from a mild flu-like illness in her first trimester and pre-term labor. Mother had negative serologies at delivery and no history of sexually transmitted infections. Delivery was uncomplicated, although placenta was noted to have presence of white nodules, and the infant did not require NICU admission. A full septic evaluation was performed with serum glucose 80, serum WBC 18.1 with neutrophilic predominance, and CSF analysis showing WBC 20,000, glucose 25, and protein 125. Blood, CSF, and urine cultures pending. What is the most likely diagnosis and the recommended empiric treatment?

1. Herpes simplex meningitis; acyclovir, ampicillin, and gentamicin
2. Group B strep meningitis; ampicillin, ceftriaxone, and gentamicin
3. Listeria Monocytogenes meningitis; ampicillin and gentamicin
4. Escherichia coli meningitis; ampicillin and gentamicin
5. Neisseria meningitidis meningitis; ampicillin, ceftriaxone, and gentamicin

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Intro/Outro- Hotshot by Scott Holmes

Disclaimer:

This podcast is intended for healthcare professionals. The information presented is for general educational purposes only and should NOT be used as professional medical advice or for the diagnosis or treatment of medical conditions.

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