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Suggest Treatment For Sepsis And Anemia In An Infant

Posted on Mon, 14 Dec 2015

Question: My baby boy has 3 months and 2 weeks. When he delivered he was 11.0 hemoglobin.
When he was 2 months he was diagnosed Sepsis and anemie, 7.6 hemoglobin. He received blood 75 ml and the hemoglobin increased to 13.3.
But now one month later the hemoglobin decreased again to 9.8.
I would like to know what can be Tha reason.
What kind of anemie he has and what is the treatment.
In the moment we are in the hospital because he has diarreia and when we made the exam found ocult blood in stool. He is taking treatment in the hospital.
Please find attached the results when he delivered, the exam before the transfusion and the exam after.

Thank you

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Can be due to milk protein allergy

Detailed Answer:
Hello

Thanks for asking on this platform

I can understand your concern. The most common cause of anemia in this age is physiological (without any underlying disease) and which needs not to be treated.
But here the hemoglobin level is very low which is unusual in physiological anemia.
A thorough investigation is needed.The occult blood in stool is positive and this suggests that there is loss of blood in stool and this can be a cause of anemia.
I have gone through the report.The only one report which could be able to find is 3 months old with hemoglobin of 11 gm%.A value less than 13 gm % in this age(below 28 days) needs blood transfusion.
The other two reports are not clear so I request you to attach the report so that I better able to help you out
Also I would like to know the feed which the baby is getting currently,as milk protein intolerance is a major cause of blood in stool.
Please get back with the answer.
Thanks and regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (53 minutes later)

Thank you Doctor for your answer. He is only taking breastfeeding I didn't introduced another feeds.
I attached again hope you find it

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Get repeat stool test and investigation for anemia

Detailed Answer:
Thanks for follow up

I have gone through the reports.The difference between pre transfusion and post transfusion hemoglobin value is about 5 gm percent.
Apart from hemoglobin and RBC values other parameters are normal for age.
I physiological anemia of infancy the value of hemoglobin can be as low as 8 gm%.
So I won't get overly worried for that but the presence of occult blood in stool is of major concern.
I suggest you to get a repeat stool test done.As you are giving only breast feed chances of protein allergy is very remote.If the occult blood is still persisting consult a pediatric gastroenterologist for expert opinion.The baby may need further investigations like colonoscopy or endoscopy to find out the cause.If there is no blood in the stool,get a repeat hemoglobin test done after one month and if it again gets decreased investigation of anemia like reticulocyte count,RBC indices and peripheral blood smear need to be done.
I have noticed that the collection date of sample was in early October the reporting date is mid November. I would like to know if it is the usual time for getting the report.

I hope this helps.
Please let me know if you have any more query.
Regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj