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Neonatal sepsis — DRCOG MCQ

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HardNeonatalNeonatal sepsisDRCOG

A 10-day-old baby has a rectal temperature of 38.3°C, poor feeding, mottled skin and a weak cry. Capillary refill is 4 seconds. The family is in a GP surgery five minutes from hospital. What is the best immediate plan?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Arrange emergency neonatal transfer for parenteral antibiotics without delaying for community tests

Explanation lettering: B = shown as A · E = shown as B · A = shown as D · D = shown as E

B is correct. Fever, poor feeding, mottling, weak cry and prolonged capillary refill are high-risk features in a neonate and require emergency hospital assessment and parenteral treatment; primary-care sampling must not delay transfer. C makes transfer conditional on incomplete community testing. D uses oral treatment for a potentially rapidly progressive invasive infection. E offers symptomatic observation despite circulatory and behavioural warning signs. A misclassifies the age and urgency: neonatal infection remains a major risk during the first 28 days. Airway, breathing and circulation support should continue while emergency transport is arranged.

Reference: NICE NG195: Neonatal infection—antibiotics for prevention and treatment: https://www.nice.org.uk/guidance/ng195/chapter/recommendations