Urosepsis simulating congenital adrenal hyperplasia in an infant

ABSTRACT

Urinary tract infection in infants simulating congenital adrenal hyperplasia is rarely reported in literature. We report a case, which was misdiagnosed as a case of congenital adrenal hyperplasia. A three-month old female infant was admitted to a local hospital for persistent vomiting and severe dehydration. Her biochemical profile revealed hyponatremia, hyperkalemia and metabolic acidosis. She was initially misdiagnosed as congenital adrenal hyperplasia [CAH]. Her urine examination revealed a urinary tract infection. Upon investigation there was no evidence of an obstructive uropathy. A full septic work up was performed and she was treated for a suspected urosepsis. Her electrolytes imbalance improved to normal and she had a complete recovery after antibiotic therapy. This case demonstrates the importance of urine culture and ultrasound examination in suspected case of pseudo-hypoaldosteronism