Neonatology

SEPTEMBER 6, 2019 FRIDAY

CALINGO / MANANDHAR/ MANANGO/ WIBOWO
Phil-health ICD: FT = Z37.0; PT = P07.3; SGA P05.1; Logbooks: NBS, HS, ROP, CUTZ, Neurodev, Neuro, Antibiogram, Ventilated
RVS: Newborn package (Inborn)= 99460
ROOM 3
CAÑADA, LYON EZEKIEL PT 29 wks by BS, 40 wks CA, RDS CBC BCS NC
83rd DOL/M s/p surfactant 1st HOL, NEC stage II 8/27 109/39/6.6/33/52/160 8/9 NG 5days RA
1.44/1.43 (IBW 1.945) resolved, Candiduria resolved, s/p 8/31 104/35/6.1/22/70/5/3/145 UDCA, EPO, Dompe,glycerine supp, GI protec, Vit
IJ catheter insertion 7/12 and CSF analysis ADEK, MVT
HN: 361464-2019 removal 8/4, HCAP, HCAI, Sepsis Pt INR PTT 8/27 Hgt 80 FeS04, AA, Zn
DOB: 6/18/19 (serratia, CONS) resolved 8/27 19.6/1.52/49.8 Protein 1.2 EBM 30cc q3 + ½ sachet HMF (Tcal 138); latch
TOB: 2:22pm Sugar 1.82
DOA: 6/18/19 Elect Xanthochromic, hazy *no wt gain
DOT: 8/27/19 BBT: 8/27 134/3.8/109/2.26 RBC 20 (90% crenated)
MBT: 8/31 136/4.40/110/2.37 WBC 0 For CBC IN AM
BW: 910g Phadebact neg For repeat ROP 9/17
BL: 37.5 BCG: Bilirubin GS (-) microorg Repeat ENBS 9/9
HC:36 Hep B: 8/31 10.5/8/2.5 CS: (-) 3 days Repeat CUTZ 90th DOL (9/13)
CC: 30 ENBS: Refer to NEURODEV
AC:29 HS:
Previous meds
Inborn, transout from NICU 8/27 ROP: 9/3 immature retina Zone 2 Vancomycin D12/14 LD 8/30
RIC: Calingo no (+) for repeat ROP after 2 Cefepime D21/21 LD 9am 9/3
Referrals: PIDS weeks Fluconazole 3 MWF

FRANCISCO, John Aldrin PT, 36wks BS, 43 wks CA, MCA CBC CXR: HL
52nd DOL/ M (Bilateral cleft lip and palate 8/12 121/37/12.9/27/61/592 8/12 atelectasis Right RA
2.29/2.36 (IBW 2.67) complete, CHD-VSD PDA) in failure, 8/14 104/31/11.8/30/59/470 8/14 Decreased infiltrates Furo (1.5) q8
8/16 136/40/14.8/31/56/468 8/17 Increased infiltrates
HCAP, Sepsis unspecified, resolved Captopril (0.05) q8, Digoxin (0.004) BID
8/21 117/35/16.2/32/52/521 8/21 Consolidation R upper lung
HN: 368694-2019 KCl (1), NaCl (1.5ml for 3 doses, 1ml every 12hrs
8/25 115/35/17.4/36/49/735 8/25 Atelectasis regression
DOB:7/18/2019 thereafter), MV
9/1 102/30/8.5/20/59/13/8/462 8/31
TOB: 11:59am BBT: A+ EBM 40cc q3 + Neosure 0.8g (24cal/oz) (tcal 90)
DOA: 8/12/19 MBT:
Elect 2D echo
DOT: 8/30/19 8/12 122/5.5/90/2.29
Post NAM fabrication
8/13 Initial VSD 4-5mm, PFO 2mm
BCG: c/o LIC 8/14 137/5/100/2.36 8/28 VSD 3-5mm, PDA 2mm, PFO 2mm
Outborn Hep B: c/o LIC 8/21 130/3.4/82/2.45 NAM adjustment on 9/12, to be worn 24/7,
ENBS: 8/15 NICU 8/25 137/4.8/92/2.73 feeding in upright, cleaned 2x a day
CUTZ
BW:2.1 kg HS: 9/1 130/3.4/84/2.44 8/13 Subacute IVH Gr 1
BL: 42 Previous meds
8/27 choroid plexus cyst, left; bithalamic
HC: 33 BCS 3%NaCl neb q8
edema
CC: 31 8/12 (-) 5D Meropenem D14/14
AC: 30 8/18 (-) 5D Combivent q8
Chromosomal analysis
Furosemide stat dose then 0.5 OD
8/15
RIC: Manandhar ABG 8/15 PRBC 10cc/kg
8/12 7.37/47/126/99/27.2/1.4 Pip tazo D5
8/15 7.3/60/100/97/29.5/1.8
KUB UTZ
Referrals: Dental, ENT, PIDS, Genta D10/10
8/16 7.33/61/67/92/32.2/4.2 8/28 Normal
Cardio NaCl (4)
8/17 7.36/52/91/97/29.7/3.4
8/21 7.46/56/86/97/39.8/14.7
Amik D7/7
8/23 7.4/16/186/100/9.9/-12.3
8/26 7.51/49/72/96/39.1/14.1

Crea
8/16 32
MIRANDA, John Jacob PT 35 weeks by BS, 37 wks CA, CBC Elec NC
15th DOL/M AGA, Colpocephaply IVH Grade 1, 8/24: 162/48/20.6/55/29/13/1/302 8/27: 140/4.4/109/2.23 Multivitamins
2.33/2.32 (IBW 2.325) Meconium Aspiration, Sepsis 8/27: 189/56/14.3/47/35/285 Dibencozide
unspecified, resolved CUTZ EBM 40 cc Q3 (tcal 94)
HN: 370633-2019 BCS 8/27/19: agenesis of corpus callosum w/ hold dropper feeding
DOB: 8/23/19 BBT: O+ 8/24 (-) 5days colpocephaly, choroid plexus cyst, bilateral Continuous phototherapy
TOB: 10:41 PM MBT: O+ chronic IVH grade 1 left;
DOA: 8/23/19 BCG – 8/24 ABG Last coffee ground: 8/25, 10 AM  lavage
Hep B – 8/24 8/24 7.46/27/180/100/19.20/-2.40 HC q 3 days: 33cm
BW: 2.31 kg ENBS – 8/27 2D- echo
BL: 49 cm HS –8/27 refer AU 8/27/19: initial PFO, mild pericardial effusion Rpt HS 9/10 (+R)
HC: 31 cm EF 84% Awaiting input : neurodev, genetic, oral rehab
CC: 27 cm Teach mother on checking on tube prior DC
AC: 23 cm WAUTZ 8/30 :initial normal RIC coordinate with gastro fellow for silicone
NGT
AS 7,8,9
Referrals: Neuro
Previous Antibiotics
Inborn Ampicillin D7/7 (12NN) LD 8/30
Transout from NICU 8/25/19 Gentamicin D5/5 (12MN) LD tom

RIC: Manango Ophtha: essentially normal eye exam

Neuro: repeat cutz after 1 month; no active
management

1
GANA, Dariel Angel Rafael PT 30 wks by BS, 34 wks CA, RDS CBC CXR HL
29th DOL/Male s/p surfactant on the 4th HOL, 8/24 114/35/16.3/36/49/565 8/22 increased infiltrates RA
1.41/1.4 (IBW 1.385) Sepsis unspecified, Apnea 2 to 8/28: 116/35/15.5/36/49/11/2/520 8/28 increased infiltrates Meropenem D7/7 LD 8/29 6am
HCAP 9/1 132/39/15.3/32/59/4/5/423 Ciprofloxacin Oral D7/7 (6pm)
HN: 368495-2019 2D echo Fluconazole (3) MWF- consume then DC
DOB:8/10/2019 Elect 8/18 Mupirocin, GI Protec
TOB: 3:59am 8/22 133/4.8/104/2.44 Caffeine (10)
DOA: 8/10/19 BBT: O+ CUTZ Last apnea 8/28 5:30pm 5secs pallor cyanosis
DOT: 8/28/19 MBT: BCS 8/13 Chronic IVH gr1 bilateral caudothalamic Lansoprazole, glycerine supp q8, Domperidone,
8/12 NG 5D junctions Vit A, Vit D, Dibencozide
Inborn BCG: 8/10 8/17 NG 5D 8/22: Chronic IVH Gr I Bilateral caudothalamic EBM 30cc +0.8g Prenan q3/ OGT (tcal 138)
Hep B: 8/10 8/22 NG3D junctions Dropper
BW: 1.16 ENBS: 8/27 8/29 (-) 5 days
BL: 39 HS:8/29 refer right, repeat on 9/12 Repeat ROP 9/12 (+R)
HC: 25.5 ABG Awaiting oral rehab input
CC: 23 ROP : 8/22 7.5/20/128/99/15.6/-5.5 WOF apnea 9/6 ( 5 sec 1 episode)
AC:23 8/28: 7.29/28/178/99/13.5/11.7 Repeat CUTZ tomorrow
CBC in AM
RIC: Wibowo Bilirubin
8/18 8.6/0/8.6
Referrals: PIDS 8/20 6.44/0/6.44
9/1 6.7/0.2/6.5

PT INR PTT
8/15 19.6/1.52/50.6
OMNES, Aquisha Gray PT 34 by BS, 37 wks CA, CBC CXR NC
22nd DOL/F Edward’s Syndrome, Neonatal 8/19 178/54/16/55/33/10m/1e/202 8/19 Pneumonia Bilateral, CHD not r/o RA
1.40/1.41 pneumonia resolved 8/24 169/50/9.9/43 39 6 12/241 Phototherapy
9/1 176/53/11.4/36/46/13/4/337 2Decho Multivitamins OD
HN: 369689-2019 BBT: AB+ 8/22 Initial: small PDA Dibencozide OD
DOB: 8/17/19 MBT: VBG EBM 30 cc + 0.8g Prenan to make 24cal/oz q3 (
TOB: 12:51pm 8/19 7.21/40/85/94%/16/-11.3 CUTZ TCAL 136) per NGT
DOA: 8/19/19 BCG: 8//27 8/20 7.36,41,54,86%,23.2/-2.2 8/20 Dandy walker variant, atrophy of
Hep B: 8/27 retrocerebellar area, posterior fossa Secure materials for home: Silicone NGT
BW: ENBS: 8/27 ABG subarachnoid cyst, giant cisterna magna
Lt: 37cm HS:8/23, refer 8/24 7.24/59/36/57/25.3/-2.9 *no weight gain
HC: 31cm Chrom ana
CC: 22cm Small face, prominent occiput, Elec 8/20 47 XX, Trisomy 18 p5 PDS once 1.5kg
AC:21cm Dysplastic ears 8/24 140/4.4/103/2.66 Repeat HS tomorrow
Short sternum 3cm (normal 6cm), WA UTZ Follow up official 2decho
Outborn shield chest, wide set nipples Crea 8/22 Mild pelvocaliectasia, left For daily bedside oral rehab
Overlapping fingers, clenched 8/24 50 Normal liver, spleen, right kidney
RIC: Calingo hands Bile sludge
Referrals: Cardio, Genetics Flexed big toe, prominent heels Bil Previous meds
8/19 11/0/11 Ampi (50) D7/7 (12nn)
Genta (4) D7/7 (12mn)
BCS
8/19 NG 3 days
HS (9/6) passed
ROOM 110
MASLOG, Andrea FT AGA, Neonatal Pneumonia r/o CBC ABG D10 IMB TFR 150
16th DOL / F Aspiration pneumonia ; 9/3 167/50/12.8/32/53/13/457 9/3 7.28/29/47/76/13.6/-11.8 O2 1 NK
3.44/3.45 (IBW 3.28) 9/6 166/49/10.7/23/61/13/2/455 9/4 7.44/36/61/92/24.5/+0.60 NCPAP Fio2 21% PEEP 4%
Hep B: DOB Afebrile
BW 3.1 kg BCG: DOB Bilirubin Ampicillin (304) D5 q8
HN: 372281-19 HS 9/3 12.2/0/12.2 Gentamicin (5) D5 q24
DOB: 8/21/2019 ENBS t/s Azithro (10) D 0/5
TOB 4:30 AM BCS Salb Neb q4
L : 50 cm BBT 9/3 neg for 3 days Suction as needed
HC 34 cm DBF with SAP
CC 34 cm CXR : progression of pneumonic Phototherapy q6
AC 32 cm opacities on both inner lung zones
If feeding tube dislodged don’t insert.
RIC: Manandhar
LABARIGO, Gavin FT AGA HIE ST II, neonatal sepsis CBC BCS HL
21st DOL/M unspecified resolved, 8/18 166/54/31.9/52/47/1/161 8/18 neg 5days RA
2.83/2.83 (IBW 2.88) Neonatal pneumonia resolved, 8/19 149/44/23.2/77/9/166 8/27 neg 3days Piptazo D8/10 (9am)
8/21 155/46/11.2/78/12/154
HCAP 8/23 137/40/11.7/63/34/116
Midazolam (0.1) PRN
HN: 309678-2019 8/27 147/44/22.5/37/56/173 Crea Levetiracetam (20) q12
DOB: 8/18/19 8/29 131/39/27.8/56/35/4/5/276 8/19 66 Domperidone, MVT
TOB: 4:10pm BBT: A+ 9/1 166/51/20/52/35/7/5/347 8/29 53 Furosemide (1) OD
DOA: 8/18/19 MBT: EBM 60cc q3 (TCal 105) via OGT
DOT: 8/28/19 CUTZ
BCG: 8/26 PT PTT 8/20 Diffuse cerebral edema SZ ep 8/18: trembling of lips, twitching of
BW: 2.6 Hep B: 8/26 8/18 36.6/2.9/68.1 9/2 eyebrows bilateral, limp
BL: 48 ENBS: 8/27 8/19 24.4/1.9/49 9/10 8/19 lip trembling, upward gaze, bicycling
HC:34 HS:9/3 Refer both ears 8/23 14.5/1.11/37.4 motion of extremities
CC: 31 EEG 8/20 upward gaze, tonic flexion Left, extension
AC:30 DAT + 9/2 Right, drooling for 3 sec, (boost of levet 10)
8/21 GTC, few sec (Levet 20 q12)
Outborn Elect CXR:
8/18 132/5.1/99/2.12 8/22 Left upper lung atelectasis
RIC: Manandhar 8/20 131/4.4/95/1.74 8/24: No atelectasis For repeat HS 9/17
8/21 136/3.9/99/1.89 8/27 pneumonia For rpt CUTZ 9/7
Referrals: Neuro, rehab 8/22 134/4.5/108/2.52
PDS
UA 8/31 st/cl/6.5/1009/neg /neg/1/1
ABG Daily oral rehab
8/19 7.35/31/113/98/17.1/-7.4
8/20 7.36/31/120/99/19.2/5.5 Secure matls for home: suction machine w/
8/21 7.4/42/90/97/26/1 (pre extub) tubings, steth, silicone OGT Fr8
8/23 7.37/40/110/98/23.1/-2.2
Previous meds:
Bilirubin Ampicillin (50) D8/10
8/21 10/0/10 Gentamicin (4) D7/7
8/24 12.8
Vit K D3/3, s/p FFp 2 units

2
 8/25 15.8 EPO q48 Day5
Amikacin D7/7 (6am)
8/23 ALT 39, AST 38

PANDOY, Mary Denise 10 DOL/ F FT AGA, t/c neonatal sepsis CBC 123/37/28.2/51 s/33 l/ 15m/1 D10 IMB TFR 150
2.5 kg (IBW : 3.12 kg) e/ 588 RA
DOB: 8/28/19 ABG 7.34/21/96/97/11.30/-12.4 LFE 9/6/19 12.40 AM 39 C
TOB: 6.30 pm Fecalysis (9/6) yellow green , soft, Ampicillin 312 mkd q8 D0+2 ( 10 pm)
BW 3.06 kg 1-2 wbc, rbc 0-1 , no ova or parasite Gentamicin (5) q24 D1(6Am)
BL 51 cm Hgt:
HC 35 cm For UA
CC: 33 cm
Previous meds:
RIC: dr Calingo PNSS 10 cc 1 hour (loose stool), mild hydration 6
hours (D5 0.3 NaCl)
ARIZOBAL Dan Reon Laya 18 D/ FT AGA neonatal pneumonia CBC (9/6) Awaiting BCS ( IVF D10IMB TFR 150 at 25 cc per hour
M 145/44/16/19/80/1/360 O2 0.5 lpm
4.075 PNSS neb q6
LFE 9/4 38 C
HN: 372697-19 Ampicillin (100) D1 (3pm)
DOB : 8-19-2019 Gentamicin (5) D1 (6pm)
HC 37 cm EBM 10 cc q3 dropper ( tcal 13)
BW
L 57
CC 38
AC 39

RIC : dr Manandhar
TABOC TABOC, Rodney PT, 29 wks by BS, AGA, 70 wks CA, CBC: CSF cultures HL
293rd DOL/M RDS s/p surfactant on 10th min of 8/19 112/36/12.1/43/43/12/459 CONS. Tr 3.5 Day 35
3.65/3.62 (IBW 4.71) life, pericardial effusion- resolved, 8/26 131/41/11.6/60/29/9/1/461 CPAP O2 4lpm, PEEP 6
S/p Arrest 12/18 x36mins, BPD 8/30 117/37/16.3/56/25/14/4/345 Rigid bronch: normal trach., can’s assess Piptazobactam D7 (3am)
HN: 331982 -2018 severe, HCAP CONS resolved, T/c 8/31 112/36/18.6/73/12/12/3/296 bronchus Gentamicin D5/7 (6pm)
DOB: 11/19/2018 bronchomalacia S/p rigid 9/5 111/34/18.9/57/28/11/4/427 LFE: 8PM 8/29
TOB: 5:15pm bronchoscopy and tracheostomy Eye discharge 8/22: - 2 days Salbu MDI 100mcg 2puffs q4 + CPT (9-1-5)
DOA: /2019 (7/22/19), Aspiration Pneumonia, Fluticasone MDI 50mcg, 1puff BID (9-9)
HCAP ABG CUTZ Prednisone tapering to DC
BW: 525g 8/30 7.38/41/179/100%/24.3/-0.8 7/30 brain atrophy Montelukast
BL: 31 MBT 0+ 8/31 7.47/42/92/98/30.60/6.30 KCl (2), Nacl (3)
HC: 21 BBT 0+ 9/1 7.43/44/178/100/29.2/4.3 CXR(APL) MVT drops, Vit D drops, CaCO3
CC: 17 9/5 7.39/56/58/89/33.9/+7/3 8/30: increase in infiltrates Fes04, dibencozide, Folic acid, VCO
AC: 15 BCG: done 9/3 resolution Domperidone, GI protec, Zn S04, HCTZ
Hep B: done BCS No seizures, spastic
AS 4,5,8 ENBS: done 8/20 (-)5 days Turn every 1-2 hours
HS: 8/30: (-) 3 days EBM 70cc q3 (TCAL 125)
Inborn, PCV next dose 9/2
Transout from NICU 8/23/19
ROP: repeat on Nov Awaiting CXR official results (9/3)
Referrals: Pulmo, Rehab, ENT, Neurodevt: HR for devt delay For BAER prior to DC
PIDS, Ophtha
Mom: 40y/o primi, hyperthyroidism 02 tank w/ gauge, humidifier, suction machine,
RIC: Wibowo hypothyroidism, pre ec severe nebulizer, ambubag, pulse ox, steth
UTZ: IUGR, w/ NRFS
NRP tom c/o ROD
(clinical abstract c/o doc Tresa) Repeated weaning HCAP reintubate
7x Piptazo shift to meropenem 120 mkd q8
Continue gentamicin
Problems: For BCS
8/9: desat, wheezes bronchospasm
Hypothermia
Awaiting UA urine KOH
8/21: eye discharge, greenish,left Repeat CXR
Tachycardia when in distress BL 140-160s Relay once available to PIDS

Previous meds:
Clindamycin
Ertapenem 14d
Amik 10d
Piptazo 5d
Azith 3d
Merop 14d
Amik 7d
Linezolid 10d (CONS)
Genta
Fluco
Budesonide
S. ampicillin D10/10 LD 8/27 6PM
Azithromycin D5/5 (9am) LD 9/4
ROOM 111
AQUINO, Franz Matthew FT, AGA, 37wks by BS, t/c sepsis CBC HL
6th DOL/M unspecified 8/31 157/49/13.3/91/9/322 RA
2.59/2.6 9/4 157/49/7.2/44/45/7/3/1/336 NFE
Hep B: 8/31 9/5 150/46/7.8/38/47/16/7/338 Ampicillin D6/7 (6a)
HN 37857-19 BCG 9/1 Genta D7/7 (12nn)
DOB 8/31/19 HS: 9/3 OD pass OS Refer ABG Continue photo
TOB 1:38PM ENBS: 9/1 8/31 7.29/37/18/21/17.8/-8.1 DBF + Supplement 10-15cc Q3

BW 2.595kg BBT: A+ BILIRUBIN

BL 51 9/4 9.3/0/9.3 For repeat HS on 9/17
HC 34 9/5 9.2/0/9.2 PDS tom, prepare baby book, refer neurodev
CC 29
AC 20 BCS:
8/31: NG x 36hrs
Inborn 9/2 NG 36 hours

Referrals

RIC: Wibowo

3
BARDE, Princess Yoona FT, AGA, Neonatal Sepsis CBC BCS HL
17th DOL/ F 8/29 160/50/9.8/33/58/47 8/29 Presumptive of gram positive cocci in RA
2.45/2.46 (IBW 2.50) 8/30 189/58/13/33/53/37 pairs and clusters Fluconazole (3) MWF
BBT: 9/2 168/50/11.2/23/59/15/2/28 9/1: CONS (20hrs) S: genta, vanco, linezolid Vancomycin D4 (5pm)
HN: 371475-19 MBT: 9/6 157/47/11.9/8/91/222 9/2: neg for 3 days Cefotaxime D7 (6am)
DOB:8/23/2019 DBF + EBM 30ml q3 (tcal 67) dropper as
TOB: 2:40am BCG: PBS CUTZ tolerated, with SAP
DOA: 8/29/19 Hep B: 8/23 8/30 Normochromic RBC, sl 8/30 initial Normal
ENBS: 8/24 anisocytosis and poikilocytosis, Encourage BF per demand
Outborn HS: sl.toxic granulations, no abnormal
cells seen, plt markedly decreased Awaiting CSF analysis
BW: 2.3kg Neg for phadebac
BL: 45
HC: 28 32 Ff up CUTZ 8/30, BCS (9/2)
CC: 2931 For urine KOH and UA
AC:31 Revise vanco 38 mg q8 (46.5 mkd)
Cefotaxime 125 mg q8 ( 153 mkd)
RIC: Manandhar

Referrals: PIDS Previous Meds

Gentamicin D1 (6am)
Ampicillin D4 (6pm)

RUBIS, King James FT, AGA, t/c neonatal SEPSIS CBC Coombs HL
12th DOL/M 9/1 172/50/10.3/46/38/14/1/437 9/2 (-) DAT and IAT RA
2.66/2.67 (IBW 2.8) BCG 9/3 9/2 184/56/13.7/61/39/469 Ampicillin D5/7 (10pm)
Hep B 8/26 9/5 Retic Cefotaxime D5/7 (5pm) 9/8
HN 371989-19 NBS 8/31 143/45/10.5/39s/41l/13m/5e/2b/48 9/2 0.7 Single phototherapy q6 hours
DOB 8/26/19 HS 9/2 5 MF 45cc Q3 (Tcal 90)
TOB 2:32pm 9/5 Bil 17.3/0/17.3 PBS
DOA 9/1/19 BBT A+ Electrolytes 9/2 normochromic RBCs no abnormal cells no Ff CUTZ done (9/5)
MBT B+ 9/1 142/5.5/109/2.59 toxic changes, platelets slightly increased Ff UP ENBS
BW 2.7kg Awaiting oral rehab
BL 50cm BCS FOBT
HC 35cm 9/1 neg for 3 days 9/4 Negative
CC 30cm
AC 27cm Bilirubin
9/1 32.5/2.5/0
Outborn 9/2 27.7/1.6/26.1
9/2 18/0/19
RIC Manango 9/5 17.3/0/17.3

CUTZ

FRAGA, Isaiah FT AGA, Omphalitis (Ecoli), CBC CSF Ana HL

25th DOL/M Neonatal Sepsis (CONS), Caput 8/21: 141/42/14.2/37/45/12/427 8/25 RA
4.22/4.25 (IBW 3.82) Succedaneum t/c congenital 8/20: 135/47/14.9/35/48/12/5/488 Xanthochromic, hazy, RBC 40876, WBC 2 NFE
hypothyroidism 8/24 145/42/11.8/30 50 6 12/534 100% lymph Meropenem (40) D11/21(5pm)
HN:369722 -2019 9/2 127/37/11.8/17/62/11/8/161 Occasional lymphocytes, no microorg Single phototherapy
DOB: 8/13/19 BBT: O+ Protein 1.10 DBF per demand
TOB: 9:38pm MBT: 0+ Bilis Sugar 2.08, 44%
DOA: 8/20/19 8/21: 18.29/0.12/18.17 CS: -3days
Ffup BCS, Awaiting official results CUTZ
BCG – QCGH 8/13 8/20: 24.7/0/24.7
BW: 3.46kg Hep B – QCGH 8/13 8/31 14.5/0/14.8 BCS
BL: 51cm ENBS – QCGH 9/5 17.2/1.5/15.8 8/20:pres of G+ cocci in pairs and in clusters Previous meds:
HC: 35cm HS – QCGH 8/20: CONS scanty growth 19h Genta (4) OD D8/10 (12nn)
CC: 36cm Coombs: 8/20: negative S: genta; TMP-SMX; Vanco; Linezolid Cefotaxime (50) Q8 D1
AC: 33cm 8/24: E.coli ESBL R to Cefotaxime, S to Genta, Oxacillin (25) D4/10 (2am)
PBS: Merop
outborn 8/20: normochromic RBCs, mod 8/31 (-) 5 days Revise meropenem to 175 mg q8 (124 mkdy)
9th HOL- jaundice face, 4th DOL- jaundice
RIC: Manango until trunk, foul smelling DC from umbi
anisopoikilocytosis, no toxic changes, from 160 mg q8 ( 113 mkday)
no abnormal cells, plt adequate Stump discharge 8/20 Repeat CBC on d 14 meropenem
GS: few G+ cocci singly and in pairs, occ G- Awaiting endo input
CUTZ bacilli Neurodev and HS on Monday ( 9/9)
8/28 initial Normal CS: E.coli, Kocuria kristinae; S: Genta
Pls save sample to TFT tom night
TFTs (elevated TSH normal T3 T4) Eye discharge
9/5 5.81/19.98/4.88 GS: no microorg Running time : 9/5 AM (Thursday)
CS: K. pneumoniae S to Genta
Elec
9/5 139/5.6/109/2.66

FIGUERAS, Coleen Alliah FT AGA HIE ST II, Neonatal sepsis, CBC BCS HL
23rd DOL/F Cephalhematoma, right parietal, 8/30 128/39/20.6/45/52/555 8/29 G(+) cocci in pairs and clusters LFE 8/31 12AM 38
3.95/3.83 (IBW 3.32) bacterial meningitis 9/2 143/41/20/26/71/3/617 9/1 CONS 20hrs S: genta, linezolid, vanco Cefotaxime (50) D7 (1am)
9/2 negative for 3 days Amikacin (15) D8/10 (6am)
HN: 371539-2019 BBT: pending Elect DBF with SAP per demand
DOB: 8/16/19 MBT: B+ 8/30 137/5.4/109/2.38 Hgt
TOB: 9:55pm 8/30 99
DOA: 8/29/19 BCG: c/o LIC UA
Hep B: 9/3 9/2 y/sh/5/1009/neg/trace/ 4/6 CSF analysis
BW: 3 kg ENBS: c/o LIC 8/30: hgt 96
L: 45 HS: Normal, c/o LIC Chon 2.3, sugar 1.65, 31%
HC: 35 Colorless, clear, rbc 48 100% cren, wbc 612

4
CC: 33 lympho 75%, pmn 25%
AC:32.5 CSF: (-) growth in 3 days

Outborn
RIC: Manango
Referrals: PIDS
PADILLA, Kyline FT, AGA, Neonatal pneumonia CBC CXR: HL
20th DOL/F 9/1 186/56/13.2/59/37/4/335 9/1 lower airway inflammation, bronchiolitis RA
3.18/3.19 ( IBW 2.46) 9/5 174/51/12.7/14/67/14/4/267 Ampicillin D5 (2pm)
Hep B Gentamicin D6/7 (6am)
HN 371939-19 ENBS c/o LIC BCS: Azithromycin D4/5 (9am)
DOB 8/17/19 HS Refer Both Ears (9/3) 9/1 no growth after 3 days DBF with SAP
TOB 12:17am
DOA 9/1/19
For repeat HS 9/17 (+) R
BW 2.2kg For ENBS c/o LIC
BL PDS ON 9/8
HC REFER TO NEURO DEV
CC
AC

Outborn

RIC Calingo

ROOM 112
INDRINAL, Mike, Abrahan FT AGA, Intestinal perforation prob Elec BCS HL
36th DOL/M secondary to HD s/p EL, peritoneal 8/11 136/5/105/2.22 8/7 E.Coli LFE 8/15 8pm 38.4
3.40/3.36 (IBW 3.96) lavage, biopsy of proximal and 8/24 135/4.9/111/2.37 8/10: CONS 15 hrs growth, S to linezolid, Amphotericin D17 (8am) LD 9/7
distal sigmoid; appendectomy; 9/4 136/5.5/107/2.5 Vanco DBF per demand
HN: 367688-2019 loop ileostomy s/p IJ cutdown, R to Genta
DOB 7/31/19 Right (8/5), POD 15; Sepsis (CONS) CBC 8/15 Candida Seen by neurodev: suggest referral to rehab,
DOA 8/04/19 followup at cns neurodev prior to discharge for
t/c VSD, Bacterial meningitis, T/c 8/11 137/41/14/53/36/9/1/40 8/25 -5 days
scheduling
wound dehiscence, Candidemia, 8/18 136/40/17.6/49/34/15/1/1/278
BW 3.4 kg Follow up official results: 2D ECHO CUTZ
BL 52 Atypical pneumonia resolving 8/24 121/35/9.8/32 55 3 8/145 Wound umbilicus CS
HC 36 8/30 105/32/10.5/31/52/9/6/148 8/10: 1. S. aureus (MRSA +)
CC 35 BBT A+ 9/4 120/38/18/33/64/3/315 2. E. faecalis; Sensi: Vanco, Levofloxacin, PDS 9/7
AC 34 MBT: Gentamicin
CXR Past meds:
RIC: Manandhar Hep B: 8/24 Wound surgical site Meropenem (40) Q8 D21/21 LD 8/29
BCG: Azithromycin D5/5
8/10: 1. S. aureus (MRSA +)
Referrals: PIDS/ Surg/ CARDIO HS : 9/2 pass both ears Fluconazole MWF
Wound GS: Occasional epithelial 2. E. faecalis; Sensi: Vanco, Linezolid,
ENBS: Vancomycin (10) Q8 D14/14 (9am) (LD 8/25)
cells, many PMN cells, no Levofloxacin, Gentamicin Genta (4) OD D10/10 6pm
microorganism seen
ROP 8/27: normal CSF analysis
UA 8/15, hgt 101
8/21 Y/C/6.5/1.003/Neg glucose/ Phadebact neg
Trace protein/1/1 GS few lympho
RBC 492, WBC none
UKOH Protein 1.4
8/21 (-) Sugar 2.01, 36%
CS: (-)3 days
Crea
8/24 25 CXR
9/4 24 8/24

Histopath: negative ganglion cells KUB UTZ

canda8/29: normal
CUTZ
8/17: except for prominent
lenticulostriate arteries, normal
result

2D ECHO
8/17 initial PFO ; EF 78 % FS 44 %
GERALDO, Khiezer FT, AGA Ruptured Meningoceole CBC CUTZ HL
20th DOL/M with microcephaly 8/31 159/49/15.4/45/41/12/2/460 8/31 Initial (-) hydrocephalus RA
2.35/2.22 (IBW 2.66) 9/5 161/51/12.8/27/73/560 Oxacillin D4
BCG 8/18 fabella Spinal UTZ Gentamicin D4
HN 371862 Hep B 8/18 fabella 9/1 t/s Meropenem
DOB 8/18/19 NBS 8/18 - Normal Electrolytes t/s Amikacin
TOB 4PM HS 8/18 - Normal 9/1 137/6.1/104/2.69 WA UTZ Nystatin mouthwash tid
DOA 8/31/19 9/2 135/5.1/101/2.48 DBF per demand
BBT B+ pT 14.8 inr 1.1 ptt 30.6
BW 2.4kg BCS For “E” LSM Repair
BL 44cm 8/31 NG x 3 Days Awaiting WA UTZ
HC 31cm
S/F UA and UKOH
CC 30cm Wound CS
AC 30cm 8/31 Pseudomonas Aeruginosa Secure 1 upRBC 100 div 3 alliquot for
(s) colistin possible OR use
Outborn (Fabella) Acinetobacter Baumanii (s)
Cotrimoxazole (I) amikacin Awaiting Input: plastic surgery/PIDS
RIC Manango

DEMILLONES HEIRESS ELISSE FT AGA leaking myelomeningocele Ret: 1.6 (9/5) IV D10 W TFR 120 to consume then HL
7th DOL / F PBS: normochromic, slight For possible repair of encephalocele
2.93 kg anisopoikilocytosis, no toxic, platelet On Saturday if stable enough and if without
adequate communication on CT Scan
HN : 372687-19 Pt/ptt : 17.20 INR 1.29 PTT: 63.20 Inform NFOD once CT Scan is done
DOB 8/30/19 CBC 179/53/8/48/50/1/1/231 Oxacillin D2

5
TOB : 9.30 AM
DOA: 9/5/2019
BW : 3.1
BL 50 cm
NEURO SQUATS
TOS TO NEURO; NEO SQUAT FT AGA 38 weeks by BS, Leaking
CALDERON, ROAN LSM Chiari II Malformation s/p
111th DOL/F repair (5/15/19); neurogenic
3.1/3.10/3.13 (IBW 4.84) bladder; solitary left kidney; S/P
VPS insertion 6/17; HCAP,
Outborn resolved, complicated UTI s/p
removal of sutures s/p Wound
HN 357265-19 dehiscence s/p re-suturing (7/17,
DOB: 5/15/2019 7/30/19), UTI (Pseudomonas
TOB: 8AM Aeruginosa), Candidemia, Septic
DOA: 5/15/2019 ileus, Atypical pneumonia
resolved, ventriculitis
BW 3.3
BL 46 s/p 1aliq transfusion
HC 3
CC 39 BBT: O+
AC 33 MBT: O+
Referral: Neuro, NSS, Nephro, NBS – 6/30
Uro, PIDS, Surg, Rehab HS – 5/17, passed AU
BCG – 6/15
Hep B – 6/15
RIC: Calingo
ROP 6/17 normal
8/27: normal
5/15 CUTZ
Chiari II malformation, mod. Non
communicating HCP with interval
progression, absent septum pellucidum,
dysgenesis of corpus callosum
6/14 Chiari II malformation, mod. Non
communicating HCP with interval
progression, absent septum pellucidum,
dysgenesis of corpus callosum
6/27 Chiari II malformation, moderate
non-communicating hydrocephalus with
interval regression, absent septum
pellucidum, small choroid plexus cyst,
right, interval dec in size of lateral
ventricle
6/18 rehab: passive ROM of all ext
Wound GS; no microorganism Cefotaxime D2
DAT + IAT –
Elec 129/6.3/99/2.31 Started NaCl 2.5 ml once daily
Cr 62 Awaiting cranial Ct Scan results
9/4 bil 20.5/0.05/20.45
Latest lab 9/6
Elc 131/4.3/103/2.29
16.14/0/16.14
CXR: pneumonia , suspicious soft
tissue mass level of L4-S1 mulitple
body defects
CBC KUB UTZ HL
6/30 109/34/12.2/35/48/9/7/422 5/31: irregular thick urinary bladder wall. Absent Right RA
6/20 111/34/12.8/53/33/11/2/1/332 kidney. Mild left Pelvocaliectasia.
6/17 114/36/10.6/33/54/8/4/255 Salbutamol neb q8
6/14 120/36/8.4/34/50/10/3/379 6/11 CXR APL + Abd LFE: 8/24 1 am 38.3
6/4 147/45/20.1/27/44/9/18/354 Eye exam: 6/4 normal Vancomycin D14/14
5/20: 133/41/17.6/59/27/8/3/ 290
5/31: 122/36/20.9/65/29/4/213 Genta D7
6/30: 109/34/12.2/35/48/9/7/422 CUTZ Amphotericin D9/21
7/7 124/37/23.2/45/42/11/341 6/6 progression of HCP LBM 08/04, LVE 08/04
7/16 116/35/13.8/18/77/6/4/326 6/27 regression of HCP
7/21 123/37/14/15/68/8/7/268 8/05: Chiari II malformation; mod non comm hcp, w/ MVT drops, Vit C + Zn
8/05: 123/39/38.7/70/20/8/1/359 interval regression; absent septum pellucidum; Domperidone, FA
8/08: 96/30/34.6/80/20/518 dysgenesis of corpus callosum PCT, Glycerine, Lansoprazole
8/10 151/47/30.8/61/27/9/2/305
8/15: Chiari II ; mod noncomm hcp w/ interval Hold FeSO4
8/11 155/47/35.8/75/19/5/1/485
progression, absent septum pellucidum; dysgenesis of DBF +EBM 65cc (Tcal 134)
8/19 119/38/15.5/52/47/162 corpus callosum
8/23: 128/38/32.6/66/30/3/1/221 8/22: Chiari II ; mod-sev noncomm hcp w/ interval
8/28: 93/28/12.4/33/53/11/2/192 progression, absent septum pellucidum; dysgenesis of
For repeat vent tap today by neurosurg
corpus callosum For electrolytes creatinine and Mg on next BE
BCS
5/20: (-) 5 days UA 8/29
6/20 (-) 5 days Straw/clear/7.5/1.003/neg/neg/1/4 Awaiting official results of CUTZ, 2D
7/8 (-) 5 days
7/31 (-) 5days ECHO(08/22)
8/05: (-)5days
2Decho
8/11: Candida spp S ampho 8/22 Neurodev referral (+) GF
8/19 Candida S: ampho Rectal Stimulation q shift if no BM
8/28 (-) 3 days Shunt tip CS 8/19 (-)2 days
Shunt valve CS 8/19: Kocuria kristinae S: URO: for VCUG-- HOLD
Elect Genta, Vanco CIC q3 c/o mother
6/17 136/4.2/98/2.65
6/4 138/4.5/112/2.4 SHUNT SERIES: Normal Ophtha: essentially normal eye exam
5/23: 135/4.4/106/2.45
VCUG Neuro: For TOS to neuro service once with vacancy.
5/31: 140/4.2/110/2.44
8/4: 134/ 3.4/99/2.33 6/7: Gr 4 left VUR at 6mL Continue oral rehab exercise (rehab refer done)
8/08: 134/4.3/95/2.38 Acute urinary retention around 50%
8/19 137/4.6/104/2.38 Fractional voiding
Previous Medications:
8/28: 143/3.3/111/2.43
Azithromycin D5/5 9pm LD 8/28
CSF Ana: Ampi sulbactam D10/10
ABG 6/18
Amikacin d7/7
6/4 7.37/18/187/100/10.4/-12.5 CSF CHON 0.5
CSF sugar 60% (hgt 90), RBC 17, WBC none Fluco (MWF)
6/15/19 Merop D12(2PM)
UA
6/17 LY, C, 1.009,6.5/+4,Tr, 2,3
RBC 87 WBC 3 100% lymphocytes, Protein 0.5 Vanco D11(5PM)
5/31: straw/ clear/ 7/1.016/-/-/2/2 Sugar 3.24 (61%), RBS 5.3 Cefepime D2
7/8 ly/sh/7/1.004/-/-/1/28 Phadebact (-), GS no growth, CS(-) 3days
Amoxicillin (10) OD -> Cefixime
7/11 yellow, hazy, 6.5, 1.011, neg gluc, prot +2, 8/19
wbc 76, rbc 27 Amik D7
Colorless, No RBC< no WBC
7/16 lt yellow, clear, ph 7, 1.003, neg gluc, neg Cefepime (150) q8 D10
prot, r1, w1 CHON 0.20, Sugar 2.37; 45%
Salb neb ½ neb q12
7/30 CS: Kocuria kristinae S: genta vanco
8/5 LY/C/7.5/1.004/+4/(-)/R3/W4 Genta (5) D10
8/30: hgt106
8/11 y/sl hazy/1.012/6.0/-/-/3/19W Ciprofloxacin (34) D7 PO
Colorless/clear/-rbc/3wbc (100%lympho),
8/23 y/sl h/7.5/1.006/-/-r3/w1 Ceftazidime (30) Q8 D5
CHON 1, Sugar 1.51, 26%
Vancomycin D14/14
Neg phadebact, No microorganism seen
UCS Cefotaxime D14
7/8 Neg x 2 days 8/30 CS: (-) 36 hours
Mannitol 7.5cc Q4 (BP90/50-60)
7/30: K. PNEUMONIAE Acetazolamide Q12
S: Colistin Creat:
5/20: 49 Cefotaxime D6/10 (5pm)
8/05: 5/31: 33 Amox OD
P. Aeruginosa(400colonies/ml) 7/8 16
Piptazo D10/10 (10pm)
08/11: (-)36 hrs 7/16 16
8/19 16 Amikacin D7/7 (5am)
Fecalysis: 8/28 18
8/06 WBC 24-26, RBC 10-15
No ova/parasite Wound GS/CS
CS(8/06): normal flora 7/28: GS few PMN’s, few gram neg bacilli, few
gram positive cocci in pairs
PT PTT CS Kocuria kristinae scanty
6/17 14.5/1.1/37 S: Genta, Linezolid, Vanco
8/19 14.4/1.1/37.5 R: Cefazolin, Clinda, Oxa, Cipro, Levo
6
 7/30 Kocuria kristinae
RBS: S: Genta, Vanco
6/4 4.1
BUN WAB UTZ (8/08):
6/4 0.7 Pelvocaliectasia left kidney, cystitis
Cannot rule out possibility of a kidney
CXR structure in ectopic or ptotic location right.
8/22 Normal Liver, Gallbladder, Pancreas and
Spleen
Abdominal Xray 8/16 Enlarged left kidney with parenchymal
8/24 disease, Normal right, hypoechoic ovoid focus
in the right suprarenal area probably arising
from the log or adrenal gland. Cystitis wotj
urine debris

TOS to NEURO; NEO SQUAT FT, AGA, Chiari II malformation CUTZ ABG HL
Neonatal sepsis (CONS), 7/27 initial ventriculitis 7/30: 7.09/43/37/47/13/-16.3 RA
PANALIGAN, Rosel Ventriculitis 8/14 Mod non-comm hydrocephalus 7/31: 7.4/47/156/99/29.1/3.6 Meropenem D5 (9am)
47th DOL/F with interval progression and with 8/01: 7.38/46/124/99%/27.2/1.6 Fluconazole (3) MWF
3.37/3.34 (IBW 4.0) sonographic signs of increased Levetiracetam BID
Hep B: 07/22 intraventricular pressure; dysgenesis BCS LSE: 08/01 4:45AM:
HN: 366675-2019 BCG: 07/27 of corpus callosum; Chiari II 7/27: Providencia stuartii, scanty Pale face and LE, Lip smacking with right and left
DOB: 7/22/2019 HS 07/29 – refer AU malformation; Ventriculitis S: Cefepime, cefotx, ceftaz, ceftri, pip-taz, movement of eyes ~10sec
TOB: 9:45 am For rpt HS 9/18 8/16: mod noncom hcp w/ interval Cipro, merop, amik, levo DBF per demand
DOA: 7/27/19 ENBS: 08/01 regression and w/ sono. signs of R: Genta, imipenem
increased IVP; dysgenesis of corpus 7/31: (-) 5days Increase meropenem 135 q8 (121 mkday)
BW 3.2 BBT B+ callosum; Chiari II; ventriculitis 08/02: CONS For TOS to NEURO c/o RIC
BL 45 MBT: 8/22: severe non comm hcp w/ 8/08: Staph CONS (incubation: 16 hours) Repeat vent tap on Thursday today c/o
HC 31 (p<2) interval regression and w/ sono. 8/14 NG x 5days neurosurg
CC 30 Cranial CT scan: 7/22 signs of increased ICP; dysgenesis of 9/1 (-) 24hrs For repeat HS 9/18 (+R)
AC 29 corpus callosum; Chiari II; t/c acute Follow up EEG and CSF CS official result
Craniospinal MRI: 8/5 ventriculitis Wound GS/CS For possible VPS once out of infection
Referrals: Neuro, NSS, PIDS, 7/27: Daily HC
ophtha Ophtha:8/28 normal eye exam CBC GS: mod gram-positive bacilli in singly and in COD OD c/o mother
7/27 127/47/14.7/33/45/5/3/55 chains
RIC: Manango 08/01 99/31/35.9/48/39/2/1/212 CS: Pseudomonas aeroginosa, scanty PREVIOUS MEDS:
Stab 1, Blast 6, Myelocyte 2, S: cefepime, ceftaz, genta, pip-taz, Cipro, Ceftazidime (30mkd) D34/42
Daily HC MONITORING Promyelocyte 1 merop, amik Fluco (6) D7/7 (9am) then (3) MWF
8/30 36cm 8/4: 135/41/26.4/83/9/32/252 Vanco D15/21 10pm LD 8/20
8/31 36.5cm
8/7 139/45/26.5/58/39/3/244 UCS Gentamicin D5/7 12mn LD 8/17
9/1 36.5cm
9/2 36cm 8/11 147/48/28/61-23-14/251 8/7 Candida, 200col/ml Cefotaxime D2 (2pm)
9/3 36cm 8/14 114/35/30.4/80/17/307 8/13 NG 36hrs Oxacillin D2 (6am)
9/4 37cm
9/5 37cm
8/18 145/44/23.6/51/26/15/7/1/450 Amikacin D10/10
9/6 8/20: 137/42/18.3/42/36/433 EEG Meropenem D11
9/7 8/23 124/37/10.4/40 36 8 15/208 8/12
9/8
9/9
8/30 108/32/10.3/38/45/246 Ophtha: essentially normal eye exam
9/10 CSF analysis
9/11 CRP 8/14 Xanthochromic, clear, RBC 17 Cren70%,
9/12
9/13 8/23 6 WBC 12 L 59%, N 41%
9/14 CHON 14.9, Sugar 0.56 11%
9/15
Elec Neg phadebact
7/27 142/2.8/106/2.11 CSF CS (-) 3 days
7/28 143/3.2/109/2.19 8/21 Sl.xanthochromic, sl. Hazy,
7/30 146/4.5/110/2.09 RBC 15, cren 90%, noncren 10%
08/01 137/3.4/101/1.99 WBC 27, lympho 100%
8/4:142/ 18/ 22/ 0.80 CHON 20.20, Sugar 0.56, 9.3%
8/14 141/4.9/107/2.49 No microorganism
8/30 138/4.8/105/2.62 CS: NG 36 hrs
8/27/19 hgt 104
TPAG: Sl. Xanthochromic, hazy, RBC 3 100%
8/4: 40/18/22/0.80 crenated, WBC 146, lympho 40%, PMN 60%
CHON 15, Sugar 0.58, 10%
Creat Phadebact negative,
08/01: 40 CSF GS negative
08/02: 36 CS -36hrs
8/14 27
8/30 20 UA
8/02: LY/C/7.0/1.003/+3/(-)/R1/W1
8/09: S/C/7.0/1.002/(-)/(-)/1R/1W
8/16 Straw/ clear/ 7.5/1.006/ R1, W2

UKOH 8/7: (-)

MATIBAG, GERALD FT AGA, Chiari 2 malformation, CBC BCS HL
85th DOL/M myelomeningocele, lumbosacral 6/20 164/50/22.6/59/41/674 6/20 (-)5 days RA
7/1 189/58/25.6/48/47/4/1/658 6/26 (-)5 days
/3.57/3.55 (IBW 4.54) area, t/c neurogenic bladder; 7/5 162/48/11.4/28/50/13/7/374 7/22 (-)5 days LFE 8/22 10:15AM 38.3C
ventriculitis; Sepsis (P. aeruginosa) 7/7 125/37/8.9/49/30/15/5/259 7/28 (-)3 days Vancomycin D25 (12NN)
Outborn s/p repair (7/6), post-op D9 s/p re- 7/15 137/40/8.8/33/45/14/6/395 7/30 (-)5 days Ceftazidime D12
7/19 129/38/11.6/39/42/11/7/534 8/10: (-) 5days
suturing 7/16 s/p EVD (7/23), 7/30 127/37/42/40/10/7/571 Fluconazole (3) MWF
HN: 361762-19 irritant contact dermatitis sec to 8/5 100/29/9.3/31/47/12/9/428 8/20: NG 36hrs Mupirocin on post op site
DOB: 6/10/2019 micropore tape vs miliaria rubra, 8/8 163/48/12.5/26/47/15/12/379 Phenytoin q12 PO
8/10: 124/37/8.8/74/19/6/1/257 KUB UTZ
TOB: 8:02AM cutaneous candidiasis, S/P VPS DBF 20 cc q3
8/14: 122/37/9.8/31/49/9/1/419 6/21 Cystitis with urine/inflammatory debris,
DOA: 6/20/2019 insertion 8/10, CNSI (CONS),
8/29: 119/35/11.9/39/41/647 significant urinary retention, mild renal
Bacterial Meningitis, s/p E VPS pelvocaliectasia, bilateral Ff up CSF CS, EEG
9/4 104/32/18.9/46/36/13/3/728
BW 3kg removal(08/21), t/c Atypical For ventricular tap today c/o neurosurg
BL 50 pneumonia VCUG 8/15: Type 1 VUR Turn patient every 2 hours
Elec
HC 35 6/20 132/5.5/98/2.55
AC 32 MBT O+ 6/26 132/4.6/101/2.43 EEG: 8/27 For transfer to room 114 under neuro
CC 34 BBT 7/4 137/5.4/108/2.11 Inform other services once transferred (neo
7/7 140/4.2/109/2.26
7/19 132/5.2/101/2.57 CUTZ neuro PIDS)
Referral: Neuro, NSS, PIDS, ENBS-6/16 outside 7/30 143/5.8/115/2.84 6/21 Mild non comm HCP, unchanged with interval Urology Notes: for KUB UTZ pre and post void
Derma/ Dr. Seng HS – 6/16 outside 8/5 133/4.8/105/2.38 progression of hydrocephalus, consider Chiari 2 after 6 mos, repeat VCUG at 2y/o; UA monitoring
8/8 133/5.6/103/2.55 malformation
BCG – 6/10 q 3mos
8/14: 136/5/107/2.46 7/9 mild non-comm hcp, right, mild to moderate non-comm
RIC: Wibowo Hep B – 6/10 hcp, left with interval improvement of ventriculitis, consider
8/20 137 5.10 196 2.52 Chiari 2 malformation Nephro Notes: CIC q4, change IFC every 5days
7/16 mild to mod non-comm hcp, consider Chiari 2
Daily HC MONITORING Derma Notes: apply petroleum jelly over diaper
8/30 39 CT scan : PT/PTT malformation
7/4 19.9/1.19/37 area on each diaper change

7
8/31 39 7/18 vermian solid mass exhibiting 7/19 13.6/1.03/40.2 8/7: mild to mod non comm hcp w/ min
9/1 38.7 increase in attenuation compared to the 8/8 14.1/1.04/38.9
9/2 38.5 interval progression, Chiari II malformation, Prev. meds:
surrounding brain parenchyma with 8/20 13.10/1/32.40
9/3 39
associated compression effects on the
Chronic encephalomalacic changes, right Azithro D5/5(9AM)
9/4 39 frontal parasagittal area Genta D10
9/5 38
adjacent structures including
compression of the 4th ventricle 7/30 8/16: mild to mod noncom. Hcp w/ min Gentamycin
9/6 38.5
9/7 considerations: medulloblastoma, ALT 37 interval progression, Chiari II malformation, Fluconazole D10/10 (9AM)
9/8 ependymoma. Contrast CT or MRI AST 62 chronic encephalomalacic changes, right Meropenem D40/42
9/9 recommended for evaluation. Mild to
9/10 moderate obstructive hydrocephalus sec.
frontal parasagittal area w/ interval Genta D10/10
9/11 Creatinine: regression Oxacillin D5
to vermian mass compression on the
9/12
fourth ventricle few short linear 7/15 19 Cefotaxime D5
9/13
9/14 hyperdensities, likely calcifications, with 7/30 19 Placode GS/CS Amikacin D14/14 (12nn)
9/15 small malacic focus-prev. hemorrhage? 8/20 20 6/23 GS occ ec,mod gram neg bacilli Ceftazidime D7/42 (6am)
CS: Pseudomonas aeruginosa, scanty Acetazolamide (22)
Cranial MRI 7/26 P/C UA S: cefepime, ceftaz, genta, piptazo, cipro, imip, merop,
amik, levoflox Hydrocortisone 1% cream BID to face and upper
Small posterior fossa, with towering 6/27 straw/SH/1.004/6.5/-/-/2/14
cerebellum with low-lying trasverse back
Neg nitrite
sinuses. In the light of lumbosacral +1 leuko (7/1) GS:Occ epithelial cells, Occ pmns, Occ gm (+) sertoconazole cream BID to diaper area, lower
myelomeningocele, findings may be 7/13 ly/cl/7.0/1.002/(-)/(-)/1R/1W cocci in singly and in pairs abdomen, thigh legs x14 days
consistent with Chiari II malformation. CS: 1]CONS
8/17 Ly/sh/7.0/1.005/-/-/R1/W6
New right frontal ventriculostomy tube in S:linezolid, vanco
place, with tip in suprasellar cistern. R:cefaz, clinda, erythro, oxa, cipro, levoflox, cotri
Gliotic changes, right frontal lobe UKOH 8/17 (-) 2] Pseudomonas
corresponding to sites of previous S: genta,, cipro, imip, merop, amik, levoflox
ventriculostomy tube placement, with UCS R: cefepime, ceftaz, piptazo
decrease in degree of hydrocephalus.
6/28 (-) x 2 days
Consider chronic parenchymal Wound (pustules)
hemorrhage, right parietal lobe 8/19: (-)36hours 7/23 GS no org seen
Consider epidural hemorrhage, left Wound CS Candida albicans
parietal convenxity likely late subacute to CSF Analysis Sensistivity: Ampohetericin, Fluconazole, Flucytosine,
chronic 7/6 (intraop) Voriconazole
Colorless, clear, rbc 6, nc 100%, wbc 38, lymoho Wound KOH moderate yeast cells with budding and
94%, pmn 6%
fungal elements seen
Prot 5.3
Sug 1.65, 35%
Phadebact neg CSF Analysis:
AFB neg 8/17 HGT 82
GS, no org seen Xantochromic clear 252 (cr20% noncr 80%)
CS neg x 3 days Prot: 1.9(3.1x)
Sug 0.9 (20%)
7/14 reddish, hazy, rbc 3875, (cr 20%, noncr 80%)
PHADEBAC (-)
CSF CHON 1.6
CSF CHO 1.7, 29% CS: CONS
HGT 106 8/22:
CSF GS mod RBC, occ lympho no org Hgt 81
CSF CS neg x 3 days
Reddish/SH/R1168(cr40, non60)/W8(lym100)
7/19 Pr: 1.90
Reddish, hazy, 2736, c30%, nc 70%, wbc none Sugar: 1.17; 26%
Prot: 1.4
Sug: 1.64, 27% GS: mod RBCS, no org seen CS: 1. CONS; (S: clinda, vanco, line)
CS: neg x 3 days 2. A.baumanii (S: genta, ceftaz,
7/23/19 (intraop): Slight xanthochromic, clear ,
cefepime, piptazo, cipro, amik, merop)
rbc 45, c 95%, nc5, wbc 3, lympho 100% 8/28/19
Prot 1.3 hgt 96
Sug 1.66, 30%
Hgt 101
Colorless, clear, RBC 32 (90%cren), WBC 1
GS: no org seen CS: (-)3days (100%lympho),
Protein 1; sugar 1.61; 30%
7/28
CSF CHO 1.57. CHON 4.4
GS neg, Phadebact neg
HGT 115 . %25 CS: NG 3 days
Xanthochromic, sl hazy, 704 RBC 70C 30NC, 4
WBC 100L
CSF GS (-)
CSF CS (-)3days

CSF Analysis:
08/02: HGT 108
RBC 1933 WBC 11 Lymph 100
CSF CHON: 3.00
CSF SUGAR: 1.06; 17.8%
CS: (-) 3Days
8/10:
CS: CONS, S: Vanco