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.