Presentation
A 21-day-old, full-term, previously healthy boy is brought in by his parents for a rectal temperature of 38.6 C (101.5 F) at home. He has been feeding less over the past 6 hours, is more sleepy than usual, and had one episode of back-arching that worried his mother. There is no cough, rhinorrhea, or sick contacts, and the pregnancy and delivery were uncomplicated.
Initial observations
- T 38.7 C (rectal)
- HR 178
- RR 52
- BP 74/44
- SpO2 98% RA
- weight 3.9 kg
This 21-day-old neonate now has a documented rectal fever of 38.7 C along with poor feeding, lethargy, and a possible seizure. What is the most appropriate initial evaluation?