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17th March 2024
A neonate who was born abroad in South Asia is admitted after the mother stated
A neonate who was born abroad in South Asia is admitted after the mother stated that he had a 1 day history of poor feeding and yellowing of the skin. Blood results were normal other than raised bilirubin. The admitting junior doctor opts to prescribe IV chloramphenicol, which is immediately switched to ceftriaxone. The neonate stabilises for the next two days but then experiences shortness of breath and appears pale. Vital signs include a heart rate of 190 and a respiratory rate of 70. Bloods are taken again, showing the following:
| Hb M(135-180g/L) F(115-160g/L) |
110 | Creatinine (55-120 umol/L) |
56 |
| WBC (4.0-11.0 * 10⁹/L) | 6.2 | eGFR | >90 |
| Neutrophils (2.0-7.0 * 10⁹/L) | 4 | Reticulocytes | 0.3% (low) |
| Platelets (150-400 * 10⁹/L) | 120 | B12/Folate | Normal |
| Clotting Screen | Normal | ||
| Na (135-145 mmol/L) | 138 | ||
| K (3.5 – 5.0 mmol/L) | 3.9 | ||
Which of the following is the most likely complication?
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