Newborn Dies From Sepsis Secondary To Undiagnosed Infection

Case Overview

The baby was seen by a primary care physician two days after discharge and there were no concerns during that visit. One week later, the baby was rushed to a local emergency room after becoming profoundly lethargic, blue in the skin, and hypothermic. The baby also had a dramatic drop in urinary output and had a reported body temperature of 90 degrees. Aggressive resuscitation efforts were started to get her stabilized for transfer to a PICU at another facility with IVF via IO’s. Antibiotics were not administered nor were labs and cultures drawn prior to transfer. The baby died several days later due to sepsis. A blood culture that had been drawn came back positive for coagulase-negative staphylococci.

Questions to the Infectious Disease and Communicable Disease expert and their responses

How often do you treat newborn patients with coagulase-negative staphylococci infections?

I regularly treat newborns with CoNS infections, predominantly in the NICU in the preemie population where it is considered a true pathogen. I have never seen an infant die from CoNS even in that population that is most at risk for it.

What are the most common risk factors for developing CoNS sepsis in a newborn?

CoNS sepsis evolves primarily in neonates in the NICU who are premature or have indwelling central venous lines that can act as a source.

About the expert

This highly qualified expert earned his BA from the University of Chicago and his MD from Columbia University before going on to complete an internship and residency in pediatrics at Mount Sinai Hospital and a fellowship in pediatric infectious diseases at Morgan Stanley Children's Hospital of New York-Presbyterian. He is board certified in pediatrics and pediatric infectious diseases and is a member of multiple professional societies, such as the Pediatric Infectious Disease Society and the Society for Healthcare Epidemiology of America. Currently, he serves as an assistant professor of clinical pediatrics, as well as an attending physician in pediatrics at a NY university medical center. Additionally, he serves as the director of their Lyme and tick-borne disease center and as the medical director of the pediatric and antimicrobial stewardship at the university-affiliated children's hospital.

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Specialties:

Infectious Disease and Communicable Disease

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.