Spontaneous hemothorax in a 28-day-old term neonate presenting with poor feeding and respiratory distress: A case report

Background Spontaneous hemothorax in neonates is extremely rare and usually presents acutely with respiratory distress. Most cases are associated with trauma, coagulopathy, or iatrogenic injury. Case presentation We report a case of a 28-day-old term neonate who presented with poor feeding and respiratory distress. On examination, the infant was pale and tachypneic. Chest radiograph revealed a large left-sided pleural effusion, confirmed by ultrasound. Pleural fluid on drainage was bloody, consistent with hemothorax. There was no history of trauma, admission, or known bleeding disorder. The infant was managed with chest tube drainage, blood transfusion, and supportive care and made a full recovery. Conclusion This case highlights the importance of considering spontaneous hemothorax in the differential diagnosis of respiratory distress in neonates, even in the absence of typical risk factors. It also underscores the importance of early point of care imaging in neonatal emergencies which can lead to earlier recognition and prompt intervention which are essential to improve survival.