Thursday, June 25, 2015

Too Young

A newborn infant is brought to your attention within 24 hours post delivery because of failure to thrive. The mother notes excessive sweating, sneezing, fever, nasal stuffiness, and yawning. He has a high pitched cry, irritability, sleep and wake disturbances, hyperactive primitive reflexes, hypertonicity, and tremors. His feeding is poor. He has some vomiting and loose stools.

His labs including glucose are normal. His sepsis workup is negative. Thyroid studies are unremarkable.

Challenge: What can you tell me abut the mother's social history?

3 comments:

Anonymous said...

Mom uses opiates / heroin

Anonymous said...

The mother likely has a history of cocaine use.

Craig Chen said...

yep! symptoms closer to opiates/heroin than cocaine.
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Too Young

This is neonatal abstinence syndrome, seen when a newborn infant born to a mother dependent on opioids is at risk for drug withdrawal. The timing is consistent with withdrawal from maternal heroin.

Source: UpToDate.