# Neonatal Adrenal Hemorrhage Mimicking Suprarenal Tumor in a 12‐Day‐Old With Escherichia coli Urosepsis

## TL;DR

A 12-day-old baby with E. coli infection had an adrenal hemorrhage mistaken for a tumor, but it was managed without surgery.

## Contribution

Highlights adrenal hemorrhage as a rare but important differential diagnosis in septic neonates with abdominal masses.

## Key findings

- Adrenal hemorrhage was incidentally found in a neonate with E. coli urosepsis.
- Conservative treatment with antibiotics and imaging was sufficient without evidence of malignancy.
- The case supports noninvasive management when malignancy is ruled out.

## Abstract

Neonatal adrenal hemorrhage is an uncommon finding that may resemble suprarenal tumors. We describe a term male neonate who developed Escherichia coli urosepsis and was incidentally found to have a left suprarenal cystic lesion. Imaging and laboratory workup excluded malignancy, and the infant remained stable under conservative treatment with antibiotics and serial ultrasound follow‐up. This case emphasizes the need to consider adrenal hemorrhage in septic neonates with abdominal masses and supports noninvasive management in the absence of malignant features.