{"title":"Sepsis Presenting as Hyperleukocytosis Mimicking Congenital Leukemia in a Preterm Neonate: A Case Report.","authors":"Bablu Kumar Gaur, Ishita Gupta","doi":"10.1891/NN-2025-0059","DOIUrl":"10.1891/NN-2025-0059","url":null,"abstract":"<p><p>Neonatal sepsis continues to be a leading cause of mortality, frequently presenting with vague clinical characteristics. Rarely, it might present with hyperleukocytosis, which closely resembles congenital leukemia and creates a diagnostic difficulty. A preterm male neonate born at 34 weeks' gestation with a birth weight of 1.8 kg was delivered to a 27-year-old G2, P1 woman in a nonconsanguineous marriage. The neonate developed respiratory distress shortly after birth. Laboratory evaluation revealed a total leukocyte count of 108 × 10<sup>3</sup>/µL (108 × 10<sup>9</sup>/L), raising concern for congenital leukemia. However, peripheral blood smear showed cytoplasmic vacuolation and toxic granules without any blast cells, and flow cytometry excluded malignancy and leukocyte adhesion deficiency. Blood culture grew <i>Acinetobacter baumannii</i> A diagnosis of sepsis-induced hyperleukocytosis was made. The leukocyte count normalized with broad-spectrum antibiotics, and the neonate recovered fully. Hyperleukocytosis in neonates is not always indicative of congenital leukemia. Differentiating between malignant and reactive causes is crucial as management and prognosis differ widely.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"196-200"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Saving the Tiniest Heinies From Diaper Dermatitis in High-Risk Neonates.","authors":"Alyssa Railsback, Kaci Karas","doi":"10.1891/NN-2025-0057","DOIUrl":"10.1891/NN-2025-0057","url":null,"abstract":"<p><p>In 2023, 53% of 300 patients in our NICU developed diaper dermatitis during their hospital stay. Literature indicates that providing effective skin care to patients can help prevent diaper dermatitis. The purpose of this project was to answer the following clinical question: Does application of Cavilon No Sting Barrier with reapplication every 3 days to high-risk newborns, either experiencing neonatal withdrawal due to maternal drug use or who were under observation for suspected infections and were noted to have blanchable redness on their buttocks on admission, prevent diaper dermatitis? This is an evidence-based project using a pre- and post-approach to reducing diaper dermatitis in a Level III NICU unit in Central Texas. Since the project started, there has been no more than a 10% rate of development of diaper dermatitis during the stay of patients who met the inclusion criteria. The recommendation is that every patient admitted to the NICU receives Cavilon applied on admission and with reapplication every 72 hours and/or after bath.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"188-195"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Late-Onset Sepsis in the Periviable Neonate.","authors":"Denise Kirsten, Kelly Sulo","doi":"10.1891/NN-2025-0049","DOIUrl":"10.1891/NN-2025-0049","url":null,"abstract":"<p><p>A female infant born at 23 0/7 weeks' gestation with a birth weight of 570 g was admitted to the NICU due to extreme prematurity, extremely low birth weight, and respiratory distress syndrome. At approximately 2 weeks of life, she underwent an evaluation for late-onset sepsis because of escalating respiratory support requirements. Empiric antibiotics were initiated while awaiting culture results. Sequential broadening of antibiotic coverage occurred in response to worsening clinical status. Despite maximal medical therapy, the infant continued to deteriorate and ultimately died following an acute bradycardic/desaturation event requiring CPR. Blood culture results returned after her death revealed Gram-negative bacteremia. This case emphasizes the treatment challenges of late-onset sepsis in periviable infants, in whom rapid decompensation from infection can occur even with aggressive antimicrobial therapy.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"170-177"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William L Hull, Meredith L Farmer, Tracey Bell, Jessica M Jones, Curry Bordelon
{"title":"Radiology Revisited: A Practical Guide for Neonatal Care Providers.","authors":"William L Hull, Meredith L Farmer, Tracey Bell, Jessica M Jones, Curry Bordelon","doi":"10.1891/NN-2025-0062","DOIUrl":"10.1891/NN-2025-0062","url":null,"abstract":"<p><p>Multiple imaging modalities are used to diagnose, care for, and manage infants in the NICU. Each modality provides unique benefits; however, radiography remains the most common. This article aims to highlight the use of x-rays by reviewing indications, applications, and a systematic interpretation-guiding process. Evaluation, common pathologies, and considerations are discussed to bridge the gap between fundamental concepts and clinical practice, thereby enhancing neonatal care. This article is designed as an educational resource for all neonatal providers and trainees. Finally, a case study allows readers to practice applying concepts in a real-world, clinically relevant context.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"178-187"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors Affecting Suboptimal Breastfeeding Practices and Their Effect on Nutritional Status of Infants in a Tertiary Care Hospital in Bhubaneswar, India: A Cross-Sectional Study.","authors":"Manisha Rakshit, Asha P Shetty","doi":"10.1891/NN-2025-0051","DOIUrl":"https://doi.org/10.1891/NN-2025-0051","url":null,"abstract":"<p><p>This is a descriptive cross-sectional study that aimed to determine the factors that affect suboptimal breastfeeding practices among mothers, assess the nutritional status of infants 1-6 months of age, and determine the association between suboptimal breastfeeding practices and the nutritional status of infants. The study was done at various pediatric wards and outpatient departments of the All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. A total of 258 mother-child dyads participated in this study. Suboptimal breastfeeding practices (which means delayed initiation of breastfeeding, discarding colostrum, giving prelacteal feeding, or nonexclusive breastfeeding) and their associated factors (maternal, socioeconomic, environmental, and infant characteristics) were assessed, as well as the nutritional status of infants and its association with suboptimal breastfeeding. The prevalence of suboptimal breastfeeding was 45.7%. Significant factors included outborn delivery (prevalence ratio [PR] = 1.50, <i>p</i> = 0.003), cesarean delivery (PR = 1.38, <i>p</i> = 0.03), preterm birth (PR = 1.47, <i>p</i> = 0.01), and lack of postnatal breastfeeding assistance (PR = 1.56, <i>p</i> = 0.02). Finally, suboptimal breastfeeding practices were associated with being underweight (<i>p</i> = 0.04) and with stunting (<i>p</i> = 0.01).</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"201-209"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Influence of Social and Community Context on the Health and Well-Being of Neonates and Their Families.","authors":"Lenora Marcellus, Miranda May Marie Amundsen","doi":"10.1891/NN-2026-0004","DOIUrl":"10.1891/NN-2026-0004","url":null,"abstract":"<p><p>Social and community context, the final domain in the Centers for Disease Control and Prevention's determinants of health framework, influences the health and well-being of neonates and their families in many ways that may not always have been considered in neonatal intensive care settings. Building on previous columns, here the impacts of social and community context are described, focusing on community cohesion, justice-related issues, and discrimination and stigma. In this column, we encourage neonatal nurses to consider how the social environment impacts neonates and families during their NICU stay and after discharge. Actions that nurses can take within the NICU setting and externally are described and resources are provided.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 3","pages":"210-216"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What Does It Mean to Be a Professional?","authors":"Debbie Fraser","doi":"10.1891/NN-2025-0072","DOIUrl":"https://doi.org/10.1891/NN-2025-0072","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"45 2","pages":"89-90"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}