A 37-6/7-week-gestation male infant born via vaginal delivery is transferred to our institution on day 13 after birth for acute liver failure (ALF). The pregnancy was complicated by poor prenatal care, maternal depression triggered by partner infidelity, and upper respiratory symptoms 3 weeks before delivery. Maternal temperature of 39.4°C was noted 6 days before delivery, which was accompanied by a diagnosis of pyelonephritis and Trichomonas vaginitis. Prenatal laboratory values were negative, and no history of genital lesions was found. Labor was induced because of preeclampsia, with artificial rupture of membranes occurring 1 hour before delivery. The infant was discharged home on day 2 but was described as a “quiet” infant who rarely awoke to feed.

On day 7, the patient had an isolated fever, with a temperature of 38.3°C that self-resolved and did not receive medical attention. On day 11, the infant exhibited a high-pitched cry and subsequently became apneic...

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