title: Sonographic Diagnosis in a Rare Aetiology of Neonatal Scrotal Swellings: A Case Report of Congenital Nephrotic Syndrome.
abstract: BACKGROUND
  Common etiologies of scrotal swelling in neonates include hydrocoele, inguinal hernia and testicular torsion; less common is epididymo-orchitis. Congenital nephrotic syndrome (CNS), a rare entity, is known to present as progressive renal failure and its leading presentation with scrotal involvement has not been reported.
  
  
  METHODS
  We report a rare case of CNS with primary clinical presentation as scrotal cellulitis and epididymo-orchitis. In this neonate, scrotal and abdominal ultrasound examination was performed and the laboratory data were obtained.
  
  
  RESULTS
  Sonography revealed bilaterally enlarged echogenic kidneys, testis and epididymis with echogenic peritoneal fluid tracking into both scrotal sacs. Laboratory data revealed proteinuria and severe depletion of serum IgG. Culture of the peritoneal fluid showed gram-negative organisms. A final diagnosis of CNS, complicated with peritonitis tracking into the scrotal sacs was arrived at.
  
  
  CONCLUSIONS
  CNS may have a rare presentation with distracting symptoms of scrotal cellulitis and epididymo-orchitis, as seen in our patient. However, diligent use of abdomino-scrotal sonography, supported by relevant laboratory data can clinch the accurate diagnosis.
authors.affiliation: Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Shabnam Bhandari
authors.initials: SB
authors.lastname: Grover
authors.affiliation: Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Nishith
authors.initials: N
authors.lastname: Kumar
authors.affiliation: At time of study: Radiology Resident Deputed to Department of Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, from Institute of Nuclear Medicine and Allied Sciences, Delhi, India, currently, Research Associate Department of Neuro Radiology, New York Medical University, New York, NY, U.S.A.
authors.forename: Hemal
authors.initials: H
authors.lastname: Grover
authors.affiliation: Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Taneja
authors.affiliation: Department of Radiology and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Katyan
keywords: Congenital Nephrotic Syndrome; Epididymo-Orchitis; Neonate; Scrotal Swelling; Ultrasound