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Early-onset neonatal sepsis — MRCPCH FOP MCQ

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HardNeonatologyEarly-onset neonatal sepsisMRCPCH FOP

A 10-hour-old term baby is grunting and feeding poorly. Mother had fever in labour and prolonged rupture of membranes; the baby has temperature 38.2°C and capillary refill 4 seconds. What is the most likely diagnosis?

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Correct answer: C — Early-onset neonatal sepsis

Respiratory distress, fever, poor feeding and delayed capillary refill in the context of maternal fever and prolonged rupture of membranes are most consistent with early-onset neonatal sepsis. Transient tachypnoea can cause respiratory distress but does not explain fever and poor perfusion. Physiological jaundice and reflux do not fit the systemic illness. The pearl is that maternal risk factors strengthen concern when neonatal signs are subtle.

Reference: NICE NG195 Neonatal infection; BNFc