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Archives of Disease in Childhood - Education and Practice 2008;93:14-18; doi:10.1136/adc.2006.109264
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health
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PROBLEM SOLVING IN CLINICAL PRACTICE

Congenital neutropenia

J Townshend1, J Clark2, A Cant2, P Carey3, P Kumar1, D Campbell1

1 Department of Paediatrics, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
2 Department of Paediatric Immunology and Infectious Diseases, Newcastle General Hospital, Newcastle Upon Tyne, Tyne and Wear, UK
3 Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, Tyne & Wear, UK

Correspondence to:
Dr J Townshend, Department of Paediatrics, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; jennyj@doctors.org.uk

The first 150 words of the full text of this article appear below.

A 4-week-old Caucasian girl presented to her local accident and emergency department with a one-day history of difficulty breathing. She had been born at 37 weeks gestation by spontaneous vaginal delivery. The pregnancy had been complicated by mild intrauterine growth restriction (weight on the 2nd centile) and maternal genital chlamydia infection at 18 weeks gestation, which had been treated with erythromycin. The delivery was uneventful but she developed respiratory distress at 24 h of age and was admitted to the neonatal unit. The results of investigations undertaken during the early neonatal period are shown in table 1. She was treated with intravenous penicillin and gentamicin for presumed pneumonia, although no organism was isolated. She improved and was discharged from hospital aged 2 weeks. On examination in the A&E the following were noted:


View this table:



  		Table 1 Blood results on day 2 of life.

 

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