A 39-week-gestation newborn shows signs of shock and thermal instability. What infection should be suspected?

In the case of a 39-week-gestation newborn presenting with signs of shock and thermal instability, the suspicion of a Strep B infection, specifically group B Streptococcus (GBS), is highly relevant. Group B Streptococcus is a leading cause of early-onset sepsis in newborns and can manifest shortly after birth with symptoms such as respiratory distress, lethargy, hypotonia, and difficulty maintaining body temperature. These clinical signs can indeed resemble shock, particularly if the infection leads to sepsis, which results in systemic instability.

Infections like GBS can occur when the bacteria are transmitted from the mother during delivery, especially if there are risk factors like prolonged rupture of membranes or maternal fever. The presentation of shock in newborns indicates a significant response to infection that compromises their circulatory system.

While other conditions listed could demonstrate some overlap in symptoms, they do not specifically align with the acute presentation of shock and thermal instability as seen in a GBS infection. For instance, Pierre-Robin Syndrome is primarily a structural condition and would not typically lead to infection-related symptoms. Necrotizing enterocolitis involves intestinal inflammation and is more commonly seen in premature infants, while pulmonary interstitial emphysema is related to respiratory distress rather