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This study reports on a male 35-week preterm neonate who was diagnosed with chronic kidney disease and referred for renal replacement therapy on day 10 of life. The ethical dilemma of deferring a lifesaving intervention was weighed against the best interest of the neonate and the family. By comparing the experiences in the current case to those reported previously, the authors present further insight into this challenging scenario faced by neonatologists. [ABSTRACT FROM AUTHOR]

Intracranial hemorrhage is a known complication in preterm neonates. We present an unusual etiology of subgaleal bleeding in a preterm extremely low birth weight neonate secondary to factor 7 deficiency. The neonate had unexplained subgaleal bleeding at the time of birth and developed a life-threatening pulmonary bleed subsequently and expired before the administration of definitive therapy. [ABSTRACT FROM AUTHOR]

The study was aimed to assess the maternal stress level due to their infant’s neonatal intensive care stay and to understand the factors contributing to it.This prospective observational study was conducted in the level III neonatal intensive care unit (NICU) of a tertiary level public hospital in India. Mothers (N = 100) were interviewed according to the Parental Stress Score (PSS) questionnaire, during days 6–8 of their infant’s admission to the NICU.Maternal stress was found to be highest due to sights and sounds in the NICU followed by alteration of the parental role. Stress due to staff behaviour and communication was least stressful followed by baby look and behaviour. The stress due to sights and sounds was significantly higher than stress due to baby’s look and behaviour [(2.7 ± 1.4 vs 1.98 ± 2.02), p = 0.004] and staff behaviour [(2.7 ± 1.4 vs 1.58 ± 1.31), p = 0.00] while was not significantly higher than stress due to parental role [(2.7 ± 1.4 vs 2.29 ± 1.60), p = 0.055]. The stress level due to baby’s look and behaviour was not significantly higher than parental role [(1.98 ± 2.02 vs 2.29 ± 1.60), F = 1.4, p = 0.23] or staff behaviour [(1.98 ± 2.02 vs 1.58 ± 1.31), F = 2.7, p = 0.09]. The demographic characteristics such as maternal age, parity, educational stress, type of delivery, gestation, need of ventilatory support, feed intolerance and kangaroo mother care (KMC) in infants individually did not significantly affect the stress scores.The involvement of mothers in neonatal care while the infants were in the NICU, early KMC and involvement of mothers in enteral feeding practices may alleviate her stress levels. [ABSTRACT FROM AUTHOR]

Facial clefts are a rare presentation with defects of the orofacial region associated with abnormalities in the soft tissues and bones. This condition has a variable presentation, often leading to aesthetic problems and feeding difficulty that affect growth and nutrition. We describe a preterm neonate diagnosed with nonsyndromic Tessier type 7 isolated bilateral facial clefts. The evaluation revealed a macrostomia with soft tissue and skin involvement with normal musculature, maxillae, mandible, and other facial bones. Timely recognition and evaluation of this premature neonate aided in better management of this condition. Long-term follow-up remains essential as plastic surgery-guided cosmetic rehabilitation, feeding, and speech therapy assessment are required for a better quality of life. [ABSTRACT FROM AUTHOR]

Fungal sepsis is a sinister infection in the neonatal intensive care unit associated with significant mortality and neurodevelopment sequelae. Very low birth weight and very preterm neonates are often predisposed and manifestations range from mucocutaneous to invasive organ involvement. Prompt recognition and treatment with appropriate antifungal improve survival and neurodevelopmental outcomes. In this report, we describe a neonate with rare dermatological manifestation in the form of a cutaneous fungal abscess with urinary tract involvement. The diagnosis was based on budding yeast cells seen on pus smear examination and culture suggestive of Candida albicans. Risk factors included birth weight <1500 g, placement of central vascular catheter, endotracheal tube, parenteral nutrition, surgical intervention, and use of broad-spectrum antibiotics. Amphotericin B deoxycholate and incision and drainage of the abscess were done to manage the abscess successfully. This report highlights the consideration of Candida as an etiological agent for cutaneous abscesses, in case of preterms with risk factors for fungal infection. Evaluation for systemic dissemination is mandatory and management with appropriate antifungal agents is critical for survival. [ABSTRACT FROM AUTHOR]

Silver hair in a neonate is an uncommon occurrence. The aetiology of this condition is varied and is associated with immunodeficiency disorders such as Griscelli syndrome and Chédiak-Higashi syndrome. A preterm neonate with Griscelli syndrome type 2 might present with just silver colour staining of hair including the lanugo hair with no other complications. In those with associated systemic abnormalities such as congenital pulmonary airway malformation, further evaluation for conditions such as Menke-Kinke hair syndrome is required. In this case series, we describe two unique cases of silver hair syndrome in preterm neonates with their clinical description, course in the hospital, role of hair mount and genetic testing for further identification and diagnosis of this disorder., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press.)