Abstract
Differentiating neonatal sepsis from non-infectious leukocytosis in jaundiced newborns is difficult and may promote unnecessary antibiotic use. This retrospective cohort study evaluated C-reactive protein (CRP), blood gas pH, and absolute lymphocyte count in 135 neonates admitted to Al-Jalaa Maternity Hospital, Tripoli, from March to October 2025. The cohort included isolated sepsis (n = 96), sepsis with jaundice (n = 35), and isolated hyperbilirubinemia with automated leukocytosis (n = 4). Groups were compared using Kruskal-Wallis and Dunn-Bonferroni tests. Isolated jaundice showed markedly higher automated white blood cell counts than isolated sepsis (52.78 ± 0.20 vs. 17.01 ± 7.22 × 10⁹/L; P = 0.0031), but normal CRP (5.00 ± 0.00 mg/L), physiological pH (7.42 ± 0.00), and preserved lymphocytes (9.41 ± 0.42 × 10⁹/L). This group had no mortality and shorter hospitalization despite universal antibiotic exposure. A combined CRP-pH-lymphocyte profile may distinguish true sepsis from non-infectious or spurious leukocytosis and support antimicrobial stewardship.