Abstract
Neonatal adrenal hemorrhage is a rare condition with various risk factors in the pediatric population. Adrenal hemorrhage commonly affects the right side in about 70% of the cases and bilateral in about 10%. It is usually asymptomatic but can cause adrenal insufficiency and sudden death. Neonatal adrenal hemorrhage should be considered even when there are no risk factors, as it can occur spontaneously with unspecific clinical presentations. Ultrasonography can confirm diagnosis, a relatively cheap and safe modality, especially for resource-limited settings. In this case report, we present a two-day-old with progressive scrotal hematoma and inguinal ecchymosis with no risk factors. Magnetic resonance imaging confirmed right adrenal hemorrhage; however, the newborn deteriorated fast, reaching mortality within 24 hours of admission. This case illustrates the importance of recognizing the condition to allow for an evidenced approach, which may include conservative waiting, as unwarranted intervention can have negative outcomes.