Prenatal discovery of a testicular mass: A rare silver lining to timely management of giant congenital inguinal hernia.

Prenatal diagnosis of inguinal hernia is significant for preparing postnatal management to ensure timely surgical interventions. Early recognition through physical examination after birth is easy and vital to confirm the post-natal diagnosis.

Kasabach-Merritt Syndrome, an underdiagnosed swollen leg in newborn with anemia and jaundice.

Key Clinical Message: Kasabach-Merritt syndrome is a rare disease. Early recognition, timely transfer, and proper management are crucial in reducing bleeding complication and mortality. Abstract: The authors report a rare case of Kasabach-Merritt syndrome in a Cambodian neonate presenting with anemia and jaundice at Day 5 of life. Since the mass was not recognized at birth, the diagnosis and treatment were delayed, thus leading to demise.

Primary congenital hypothyroidism: challenges in a low-income country without paediatric endocrinologist and universal newborn screening.

Due to the lack of public awareness, congenital hypothyroidism (CH) remains an overlooked challenge in Cambodia. This disease should be screened routinely at birth because, though asymptomatic, it can lead to mental retardation in the absence of early treatment. Since 2013, our unit has been the only centre that implements routine screening and provides treatment and follow-up. This case report highlights a long and tough journey of a girl who, after being diagnosed by routine newborn screening, came for follow-up at our centre. Since the screening has yet to be recognised nationally, we want to raise not only awareness of CH but also the difficulties faced by parents because their children are in need of life-long treatment in a low-resource country. Thus, the key to successful management of paediatric patients is their parental involvement, which can be influenced by their educational, cultural, geographical and financial background.

Early-onset neonatal sepsis due to Streptococcus salivarius: A case report.

Streptococcus salivarius, the most predominant human oral microbiota, is rarely associated with neonatal sepsis. This report aims to describe a rare culture-proven case of early-onset sepsis in a 3-day-old boy with isolated high-grade fever. Streptococcus salivarius was isolated in two consecutive hemocultures and unexpectedly resistant to the conventional empirical antibiotics.

Congenital chikungunya in a neonate with early-onset sepsis and petechiae: An unusual case report.

Chikungunya, a mosquito-borne disease, is posing threat to neonatal population in Cambodia because of its challenging diagnosis and insufficient attention compared with Dengue. In what follows, we present a case of serologically-confirmed congenital chikungunya in a newborn presenting early-onset sepsis, and the mother was underdiagnosed with intrapartum flu-like infection.

Complete heart block in neonatal lupus: a forgotten cause of fetal bradycardia.

The most common cause of congenital heart block (CHB) is neonatal lupus, an acquired autoimmune disease caused by transplacental transfer of maternal antibodies to the fetus. A full-term female neonate was admitted to neonatal intensive care unit for severe bradycardia with stable haemodynamics. The mother, showing no clinical symptoms or any particular history, was transferred to our tertiary centre for profound fetal bradycardia. At birth, the infant's ECG showed a third-degree atrioventricular block and echocardiography was normal. Cardiac neonatal lupus was confirmed with positive maternal anti-Ro antibodies. Under close monitoring, the infant tolerated the bradycardia well (median 67 beats per minute (bpm)) and was discharged on day 6 of life. There was no indication for pacemaker, but she would be on regular follow-up with a paediatric cardiologist. This article holds an important insight as it is the first confirmed case of autoimmune CHB in Cambodia in which the mother's antibody was found only after diagnosis on the neonate.

Congenital Syphilis Coinfection in a Preterm Infant with Early Onset Sepsis due to Enterobacter cloacae.

INTRODUCTION: Syphilis is a tropical disease, caused by a spirochete Treponema pallidum, which can be transmitted transplacentally from untreated mothers to the fetus during any stages of pregnancy. Clinical manifestations of early congenital syphilis are variable and nonspecific. The diagnosis is based on the serology status of the mother, newborn clinical symptoms, and comparative serology titer between mother and newborn. Case Presentation. A late preterm female infant, appropriate for gestational age, was treated for severe early onset sepsis due to Enterobacter cloacae since day 2 of life. The coinfection with Treponema pallidum was suspected and confirmed at day 4 with clinical signs and a fourfold increase of rapid plasma reagin (RPR) compared to mother's serology. Combined with meropenem and amikacin, Benzyl-Penicillin was used for 10 days, thereby resulting in a significant clinical and laboratory improvement. The girl was discharged at day 18 and brought for regular follow-ups for both growth milestone and syphilis serology. RPR decreased fourfold at the age of 1 month. CONCLUSION: Syphilis should not be overlooked. The vertical transmission is preventable by an on-time treatment of the infected mother, triggered by a proper antenatal screening at the right time. Congenital syphilis should be ruled out in any challenging neonatal sepsis. The diagnosis tools and treatments are easily accessible and inexpensive in our economical settings.