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Chapter 3 Clinical signs of serious neonatal illness Lethargy Chest in-drawing (Ref. p.87) Nasal flaring (Ref. p.87) Abdominal distension - cellulitis (Ref. p.54) Purpuric (septic) spots, abdominal distension (Ref. p.168) Abdominal distension: bowel obstruction (Ref. p.283) Jaundice, abdominal distension (Ref. p.64) Look for localizing signs • Pus draining from ear • Skin pustules • Umbilical redness extending to the peri-umbilical skin or draining pus • Painful joints, joint swelling, reduced movement Cellulitis / osteomyelitis (Ref. p.288) Septic arthritis (Ref. p.186, 289) Skin pustules: staph infection Breast abscess (Ref. p.287) Fever and umbilical redness and swelling (Ref. p.54) Conjunctivitis (Ref. p.66) Suspect meningitis if: • General illness – Irritability – Vomiting everything – Lethargy • Tense or bulging fontanelle • Stiff neck (late) • High pitched cry • Apnoeic episodes • Convulsions Bulging fontanelle (Ref. P.54) Trismus and increased muscle tone neonatal tetanus (Ref. P.25) Birth Asphyxia Ref. p. 47-49, 51 Birth Asphyxia (Ref. p. 47-49) Congenital syphilis (Ref. p. 67)