MDM //

otherwise healthy, full term, brought in by parents for 1 day_ of increased fussiness. Afebrile, full term, currently well appearing, nontoxic. Given history and exam, low suspicion for serious bacterial infection including meningitis, pneumonia, UTI or bacteremia. Tolerating PO and appearing euvolemic with appropriate linear weight gain since birth. No meningismus, otherwise at baseline activity level with low suspicion for CNS infection. Patient wearing mittens_, no excessive tearing or redness, and without long nails with low suspicion for corneal abrasion. No overt evidence of NAT or hair tourniquets. No malignant rashes noted and improving diaper rash per parents on exam. Discussed strict return precautions for worsening of symptoms, increased respiratory effort, signs of CNS infection including but not limited to changes in mental status or vomiting, or fever. Discussed prompt follow up with primary pediatrician in 24-48 hours for recheck or return to ED sooner if concern or if cannot schedule appointment.



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