Assignment Task:
7-week-old Max was born at 39 weeks gestation via normal, vaginal delivery, to a group B strep-negative mom. Mom reports that she had a normal pregnancy with Max and delivery was without complications. His newborn screening was negative. He was well until he woke up at 4 a.m. crying. He felt warm and did not seem himself. For immunizations, he has only received hepatitis B. His temp was measured rectally and he did not receive an antipyretic. He has a 2-year-old brother who attends daycare, but there has been no known ill contacts. The family has not traveled. Mom states he nursed for for about 5-10 minutes in the past 4 hours. He has a wet diaper in the clinic. You perform a thorough ROS, which is negative, except for the fussiness, but he is consolable. He takes vitamin D daily and has no past medical history.
Exam: Rectal Temp 100.8 degrees F, HR 120, RR 40, PaO2 98%
He is sleeping comfortably, but he arouses easily to stimulation. He is nontoxic appearing; skin color pink and warm, cap refill 2 seconds. No rashes noted, he has normal tone and fontanels. The remainder of the exam is normal.
What is your differential diagnosis? What will you do next? Provide your answers and watch the following lectures.