CLINICAL HISTORY.—This 5-day-old infant was admitted to Childrens Hospital, Los Angeles, with a diagnosis of a possible sepsis. He was born by cesarean section after approximately 24 hours of labor with ruptured membranes. He weighed 9 lb 4 oz (9,196 gm), and required tracheal catheter resuscitation. Bruising was noted over the upper back, and because of some respiratory distress, he was kept in oxygen until he was three days old. The night before admission, his temperature was 101.8 F (38.8 C). Apparently, feedings had been taken well, but he seemed to tire easily with nursing.
The mother's pregnancy was uncomplicated, and the family history noncontributory.
Upon examination, the patient was an alert, pink, and healthy-appearing infant in no distress. The fontanel was flat and the neck supple. No abnormality was detected in the ears, nose, or throat. Questionable dullness was noted over the right chest, but otherwise, the examination of