Past Medical history:
The neonate was born via emergency lower segment Caesarean section due
to polyhydramnios and non-reactive cardiotocography. The baby weighed
1.7kg, had delayed cry, and had an APGAR score of 4/10 then 8/10, after
the first cry. Initial management included bubble CPAP (BcPAP) in the
nursery before being transferred to NICU on day 2 of life.
During the NICU stay, the baby was diagnosed with Bartter
syndrome, supported by laboratory findings of hypokalemia, hypocalcemia,
metabolic alkalosis, hypomagnesemia, and elevated serum renin and
aldosterone levels, and later confirmed through genetic testing. This
diagnosis was further supported by a family history of a sibling’s death
at 2 months of age, suspected due to Bartter syndrome. The patient also
developed Klebsiella pneumoniae meningitis during the NICU, requiring
extensive antibiotic treatment.