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Spontaneous neonatal scrotal haematoma: an early manifestation of severe haemophilia
  1. Jeffrey Soon-Yit Lee1,2,
  2. Chae-Hee Chieng2,3,
  3. Macprihelna Martin3 and
  4. Teck-Hock Toh1,2,3
  1. 1Clinical Research Centre, Sibu Hospital, Sibu, Sarawak, Malaysia
  2. 2Faculty of Medicine, SEGi University Kota Damansara, Petaling Jaya, Selangor, Malaysia
  3. 3Department of Paediatrics, Sibu Hospital, Sibu, Sarawak, Malaysia
  1. Correspondence to Dr Jeffrey Soon-Yit Lee; jeffsylee{at}


We report a term newborn who presented on day 3 of life with unilateral, tender scrotal swelling with skin discolouration, which was subsequently diagnosed as haemophilia A at about 6 months of age. He received intramuscular vitamin K and hepatitis B vaccine at birth uneventfully. The scrotal swelling was treated as an infected hydrocoele, considering the absence of a family history of bleeding disorder and other risks of bleeding tendency, as well as the ultrasonographic features. He also had congenital pneumonia requiring venepuncture, non-invasive oxygen supplementation and intravenous antibiotics, without any complication. The swelling slowly improved over 2 months. He later developed post-trial vaccine injection haematoma at 4 months of age, and multiple non-traumatic bruises when he was 6 months old, leading to the diagnosis. This case demonstrates an uncommon, but a possible, early manifestation of haemophilia A at birth with a unilateral scrotal haematoma.

  • haematology (incl blood transfusion)
  • paediatrics
  • paediatric surgery

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  • Contributors JS-YL: conceptualised, designed and drafted the first draft of the manuscript and approved the final manuscript. T-HT and C-HC: conceptualised and designed the manuscript, critically revised the manuscript as submitted and approved the final manuscript. MM: critically revised the manuscript as submitted and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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