Traumatic Fat Necrosis Complicated with a High Platelet Count and Anaemia in a Nigerian Neonate

Victor Idowu Joel-Medewase, Risikat Opeyemi Qlaiya, Olubukola Oluwayemisi Olusola-Adokayo, Waheed Akanni Oluogun
2019 Journal of Clinical and Diagnostic Research  
A 26-day-old female baby, at the infant welfare clinic, reported with complaints of an insidious but progressive swelling of both cheeks noticed 5 days before presentation. The swellings had increased slowly and progressively from the size of a bean seed (about 0.5 cm) to almost double this size over five days. The swellings were not painful and the one on the left cheek was bigger in comparison to that on right. No redness was noticed around the swellings. The baby was well and fed well. She
more » ... s neither febrile nor irritable. The mother was worried because the swellings had not resolved in 5 days [Table/ Fig-1 ]. On further assessment, baby had features suggestive of hypoxic ischaemic encephalopathy (stage 2). This was managed according to hospital protocol. Baby had features suggestive of neonatal sepsis hence septic screen was done and started on intravenous Cefotaxime and Gentamycin. The results of the investigations done on day three are shown in [Table/ Fig-2 ]. Platelet count was normal. The blood culture was negative after incubation for 72 hours. The electrolytes and urinalysis investigations, done during hospitalisation, were also normal. The baby was discharged to the neonatal clinic for follow up after 11 days of Hospital stay, following resolution of signs of perinatal asphyxia and neonatal sepsis. There was no sign of haemorrhage or thrombosis during stay of following discharge. However, the mother brought the baby back with complaints of localised facial swelling at age 26 days. Examination of the baby at 26 days of life revealed a well looking baby except for the nodular swellings on the malar area of the cheek and upper central portion of the trunk, posteriorly. A non-tender nodular mobile mass over both malar areas of the cheeks and a similar indurated mobile mass on the upper half of the posterior trunk were detected [Table /Fig-3 ]. Victor idowu Joel-MedewaSe 1 , riSikat oPeyeMi Qlaiya 2 , olubukola oluwayeMiSi oluSola-adokayo 3 , waheed akanni oluogun 4 ABSTRACT Traumatic fat necrosis is a rare, temporary and self-limiting condition. It is believed to be caused by panniculitis, or inflammatory change in fat tissues following trauma, cold or ischaemic insult. We report the case of a baby who presented with firm nodular bean seed sized swellings on both sides of the cheek and back, noticed 26 days after a difficult vaginal delivery. A platelet count of 461,000 cell/mm 3 was recorded in the patient. The traumatic and haematological aberrations resolved spontaneously, after few weeks. We report the case to increase the awareness of health providers on the occurrence of such complications and to emphasise the need to promptly detect and manage them. [Table/ Fig-1] : Showing raised indurated traumatic fat necrosis lesion on the right cheek.
doi:10.7860/jcdr/2019/39892.12845 fatcat:cauh72u7xbbhdglzj7ziuyobi4