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A term neonate was born by forceps extraction with meconium stained liquor. He was admitted to high dependency neonatal unit for respiratory distress (venous blood gas (VBG): pH—7.23, pCO2—6.18) and low blood sugars. He received intravenous antibiotics for 36 hours and discharged home on day 5 of life.
On day 11 of life, mother noticed a lump behind his left axilla with purplish discolouration (figure 1). More such lumps were noted in the next 4 days. Two firm purplish lumps measuring 3×3 cm on left posterior axilla and 2.5×2 cm on right posterior axilla were palpable (figure 2). Multiple palpable lumps of smaller size were noticed over his back up to the mid-thoracic region (figures 2 and 3).
Contributors SSK has seen the neonate at the time of presentation along with RNA and managed the case initially. She contributed by liasing with the medical illustration to release the images. She took consent required both for the trust and BMJ from the mother of the neonate and also wrote the description for the articles which was slightly changed by RNA. RNA guided throughout the process and gave ideas to start writing the description and helped in going through the description and made relevant changes.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.