An Infant with Bruising and Lethargy

Abstract

A newborn who presents for care with bruising, lethargy, or poor feeding requires immediate evaluation. It is important to take a complete history and physical examination to determine what further testing is warranted. Differential diagnoses should include, but are not limited to, nonaccidental trauma, sepsis, or clotting disorders. A history for the baby should include newborn medications after birth, vaccination history, nutrition, and any social information pertinent to the living situation. Maternal medical history should include a list of current medications as well as those taken during pregnancy, any complications related to pregnancy or birth, and pertinent chronic health problems. Bruising on a baby in the first year of life should include laboratory work and may indicate additional radiologic studies to assess for intracranial hemorrhage. This article will help the clinician work through a case study for evaluation and treatment.