Idiopathic Neonatal Priapism Presenting as Persistent Penile Erection: A Case Report from a Low-Resource Setting

Neonatal priapism is an exceptionally rare condition, most often non-ischemic and self-limiting. We report a 13-day-old Somali neonate presenting with a painless penile erection lasting 32 hours. The infant was clinically stable, with normal laboratory findings and preserved penile perfusion. In the absence of identifiable secondary causes, a diagnosis of idiopathic non-ischemic priapism was made. Due to reassuring clinical features, conservative observation was undertaken. Spontaneous detumescence occurred without pharmacologic or surgical intervention, and follow-up showed no recurrence or complications. This case underscores the importance of clinical assessment and supports conservative management of neonatal high-flow priapism, particularly in resource-limited settings • Persistent penile erection in newborns is extremely uncommon and is usually a harmless, high-flow variant. • A detailed history and careful physical examination are often enough to rule out the dangerous ischemic form. • When laboratory tests are normal and no underlying disorder is identified, the condition is most often idiopathic. • Close observation without medication or surgery commonly leads to complete and spontaneous resolution. • In resource-limited settings, thoughtful clinical judgment can ensure safe care while preventing unnecessary interventions and parental distress.