Which additional test should be performed alongside blood cultures when assessing for sepsis in ill-appearing newborns?

• A. Abdominal ultrasound
• B. Chest radiography
• C. Kidney function tests
• D. Complete metabolic panel

Answer: (B)

When assessing for sepsis in ill-appearing newborns, performing chest radiography is crucial alongside blood cultures because it helps in evaluating potential pulmonary complications associated with sepsis, such as pneumonia or pleural effusion. Newborns with sepsis are at significant risk for developing infections in the lungs due to their immature immune systems, and chest radiography can provide valuable diagnostic information that is essential for timely intervention.

Other tests, while important in different contexts, do not directly assess conditions frequently related to sepsis. For instance, an abdominal ultrasound may be used in cases of suspected intra-abdominal infection but is not typically first-line. Kidney function tests and a complete metabolic panel can help assess overall organ function and electrolyte balance but do not specifically focus on respiratory complications that might be present in the context of sepsis. Thus, chest radiography stands out as the most relevant additional test to guide clinical management in these infants.