Case 12-2015: A Newborn Boy with Respiratory Distress, Lethargy, and Hypernatremia

New England Journal of Medicine 372(16):1550 (2015) PMID 25875261

A newborn boy was admitted to the hospital because of respiratory distress and hypotension. At delivery, meconium was suctioned from the airway. Respiration and blood pressure improved after intervention, but lethargy and myoclonus developed. Presentation of Case Dr. Adam W. DeTora (Pediatrics): A newborn boy was admitted to this hospital because of respiratory distress and hypotension. The patient was born at another hospital to a 25-year-old mother by normal spontaneous vaginal delivery after a full-term uncomplicated gestation. Results of prenatal ultrasonography at 19 weeks 6 days of gestation were reportedly normal. During labor, the mother’s temperature rose to 39.4°C, and meconium staining of the amniotic fluid was noted. Clindamycin and gentamicin were administered. During delivery, meconium was suctioned with a bulb syringe from the infant’s nose and mouth. The baby was limp and blue, . . .

DOI: 10.1056/NEJMcpc1400837