A 12-Day-Old Boy Is Brought to the Emergency Department by His

question 509

Multiple Choice

A 12-day-old boy is brought to the emergency department by his parents due to poor feeding.  The patient is exclusively breastfed but has been less interested in feeding since last night.  He was born via scheduled repeat cesarean delivery.  Maternal group B streptococcal screening was positive, but intrapartum antibiotic prophylaxis was deferred due to the planned cesarean delivery.  The pregnancy was otherwise unremarkable, and the infant had an uncomplicated nursery stay.  The patient's 3-year-old brother attends day care and has had rhinorrhea and cough this week.  Temperature is 35.1 C (95.2 F) .  Physical examination shows a hypotonic, lethargic infant with a full anterior fontanelle.  Initial laboratory studies reveal a leukocyte count of 2,000/mm³ with 20% bands.  During the evaluation, he becomes apneic and requires intubation.  Which of the following is the most likely cause of this patient's condition?

• A)Group B Streptococcus
• B)Haemophilus influenzae
• C)Listeria monocytogenes
• D)Neisseria meningitidis
• E)Streptococcus pneumoniae
• F)Toxoplasma gondii

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Definitions:

Hydrolysis

A decomposition reaction involving water and commonly producing clays, as in soil.

Thermal Expansion

The expansion of material as it is heated, such as heating and cooling that cause different minerals, or different parts of a rock, to expand and contract by different amounts.

Barrier Islands

Narrow, elongated islands lying parallel to the coast, formed largely of sand, protecting the coast from erosion and storms.

Coastal Accumulations

The build-up of sedimentary materials, such as sand and gravel, along coastlines due to oceanic and tidal movements.