Newborn delivered SVD,poor activity n poor sucking since birth. Cry on stimulation + . Eye opening + , CVS :- normal , chest:- clear ,P/A:- soft n bowel sound + , Ant.Fontonelle:- normal. Tc:- 8000 ,CRP:- 25 , B.Sugar :- 90. Dx n Mx :- ?

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Poor activity, poor suck with normal tone.. reflexes? Antenatal history? CRP s/o EOS.. Flat ribs normal in neonate but ICS wider then usual.. Need LP, blood culture, s calcium, vit d3 levels, thyroid profile and CPK. Then nxt line of metabolic screening.

Dear Dr. Sunil What's wt & term? Baby is mostly lethargic RBS-N TC-WNL CRP +ve Plz do S. Calcium, TSH Eectrolytes Blood culture Is there hypotonia 2D Echo Dx EO sepsis/ meningitis Hypothyroidism Wording Hoffman

Thnx sir Wt:- 2.6kg Tone is normal No floppiness
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Seems like case of perinatal asphyxiation , Is there any history of PROM? Apgar 1,5,20 minute Dr Sunil?? Any subtle convulsions?? Or excessively jittery @Dr. Sunil Soni

No seizure/ jitteriness, no PROM , Apgar was 9. Cried after birth +
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@Dr. Sunil Soni rule out werding Hoffman disease ,advise CPK, Another investigations like IONIZED CALCIUM, TSH , PTH,

Thnx Sir...
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Send blood c/s n treat neonatal sepsis with first line antibiotics . R/o myopathy and congenital hypothyroidism.

Hi Dr Sunil Something we r missing here Very interesting case Newborn Vaginally delivered Poor suck Tone normal TC normal B sugar normal CRP elevated I think of some maternal intoxication or drug intake prior to delivery Second is syndromic /genetic CAUSE Third Is IEM

But again poor suck normal tone doesn't go hand in hand Can Think of myopathy as one more DD
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CRP increased, consider EOS. Adv sepsis screening, s.electrolytes, CSF exam, PTH, TSH, CPK, bld culture, s.creat and treat accordingly. Second, think about antenatal history i.e intoxication or any drug Third about IEM and myopathy

This Infant with poor suck & activity : D/D : HYPOTONIA DUE TO CNS LESIONS. SYNDROMIC DISORDERS. INTRAPARTUM SEPSIS. TORCH INFECTIONS. DOWN SYNDROME.

Tone is normal Face is normal
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Sepsis screening

Initially baby was not responding to taxim n amikacin but after 24hr of life when meropenem n calcium were added then response was nice now at 36hrs of life baby has started to suck n activity is improving. I think it's a case of EOS. But unable to find out d cause of EOS.

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