By Bradley S. Marino MD MPP MSCE, Katie S. Fine MD
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Extra info for Blueprints Pediatrics
The risk is highest in patients with dark skin who, due to their climate or otherwise, are exposed to very little sunlight. Both breast milk and current commercial formulas provide sufficient iron to infants. Hemoglobin and hematocrit levels decrease slowly in the term infant to a “physiologic nadir” sometime between 8 and 12 weeks of life. During this period, hemoglobin values as low as 9 mg/dL are considered normal. Shortly thereafter, the hemoglobin begins to rise in response to infant marrow production of cells.
Results of the arterial blood gas testing and chest radiograph are noted in Table 2-7. A complete blood count, when obtained, is not suggestive of infection. Although the studies listed are helpful, TTN is essentially a diagnosis of exclusion. Management of the illness parallels the severity of the presentation. Mildly affected infants (the great majority) may need only supplemental oxygen delivered via hood. When hypoxemia persists despite 100% hood oxygenation, nasal CPAP is used. This is generally all that is needed.
Infants may also become infected through contact with herpetic breast lesions while feeding or from maternal oral secretions after birth. Presentation: Neonatal HSV presents in the first 4 wk of life with any of the following three distinct clinical pictures: Isolated mucocutaneous lesions (skin, eye, and/or mouth), including keratoconjunctivitis Encephalitis Disseminated disease involving multiple organs (lungs, liver, often CNS) Infants with encephalitis and/or disseminated HSV disease may not manifest the characteristic vesicular skin lesions, leading to a delay in diagnosis.
Blueprints Pediatrics by Bradley S. Marino MD MPP MSCE, Katie S. Fine MD