Typical exam stem
A 10-day-old infant presents with poor feeding, lethargy and temperature instability. How would you assess and manage possible neonatal sepsis?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
What are subtle clinical features of neonatal sepsis?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Presentation may be subtle
Neonatal sepsis may present without a clear focal source. Poor feeding, reduced activity, temperature instability, respiratory distress, apnoea, jaundice, vomiting, seizures, abdominal distension or poor perfusion should raise concern. A normal temperature does not exclude serious bacterial infection.
Stabilise and investigate
- Assess airway, breathing, circulation, glucose and temperature immediately.
- Obtain blood culture before antibiotics when this can be done without dangerous delay.
- Perform full blood count and other tests according to severity and local protocol; inflammatory markers can support but not independently exclude infection.
- Consider lumbar puncture when meningitis is suspected or when indicated by the clinical pathway and the infant is stable enough.
- Assess urine and other cultures according to age, presentation and local guidelines.
Treat early and reassess repeatedly
Start age-appropriate empiric intravenous antibiotics promptly in a sick neonate with suspected serious bacterial infection. The regimen should reflect local resistance patterns and whether infection is early or late onset. Treat hypoglycaemia, shock, hypoxaemia and seizures in parallel.
Review culture results and clinical response to narrow, stop or extend therapy appropriately. Failure to improve should prompt reassessment for meningitis, resistant organisms, congenital infection, metabolic disease or a non-infectious neonatal emergency.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.