A 4-day-old infant presents with lethargy, vomiting, acidosis, and has a seizure upon arrival.

Inborn errors of metabolism (IEM)often present within thefirst few days of lifewithnonspecific symptomslike poor feeding, vomiting, lethargy,metabolic acidosis, and seizures. These disorders impair the body's ability to metabolize proteins, fats, or carbohydrates, leading totoxic metabolite accumulation.

“Infants with inborn errors of metabolism commonly present in the first week of life with lethargy, vomiting, seizures, and metabolic acidosis. Prompt recognition is critical.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Metabolic Disorders and Acute Presentations)