Review Question - QID 207537

An 8-month old male infant is brought to the emergency department by his mother for lethargy. She reports he has been sleeping more and eating less than normal over the past week. Today he has not been rousable enough to feed at all. She suggests he has the same cold that has been going around her workplace and requests antibiotics. She reports the child was the product of a normal pregnancy and delivered without complications. He has not seen a pediatrician since 2 months of age but she reports he has been developing normally. He is watched by his mother’s boyfriend during the day while she works. On exam the child is difficult to arouse with normal vital signs. There is a blue/gray patch on both the right upper extremity and buttocks as well as a 1 cm burn on the dorsal side of his right foot. What is the next step in your evaluation of this child?
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