PEDIATRICS Vol. 72 No. 4 October 1983, pp. 562-564
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Fatal Intracranial Hemorrhage in a Normal Infant Secondary to Vitamin K Deficiency

PETER A. LANE MD1, WILLIAM E. HATHAWAY MD1, JOHN H. GITHENS MD1, RICHARD D. KRUGMAN MD1, and DONNA A. ROSENBERG MD1

1 Department of Pediatrics, University of Colorado School of Medicine, Denver

Since the initiation of routine vitamin K prophylaxis in newborns, the incidence of hemorrhagic disease of the newborn has been dramatically decreased. Recently there have been suggestions in the literature that prophylaxis may be unnecessary.1-4 We report here a fatal case of vitamin K deficiency in an otherwise healthy 1-month-old who did not receive prophylaxis. This case is illustrative because the child was initially thought to have suffered nonaccidental trauma. In addition, the correct diagnosis was confirmed, retrospectively, after vitamin K administration, with new assays for vitamin K-deficient prothrombin.

CASE REPORT

This 4-week-old male infant was seen at a community hospital emergency room with a one-day history of irritability, poor feeding, and decreased responsiveness without fever.

Submitted on December 13, 1982
Accepted on January 25, 1983