A 6-Day-Old Newborn with Vomiting and Jaundice

  • Efe Okotcha Texas Tech University
  • Abbie Biggers
  • Jonathan Martin
  • Raphael Mattamal
Keywords: jaundice, hyperbilirubinemia, pediatrics, urinary tract infection, malrotation


Sixty percent of term neonates and 80% of preterms have jaundice within the first week of life. Jaundice can be pathologic or physiologic, indirect, or direct. Indirect jaundice can be neurotoxic at high levels. In its most severe form, this presents as acute bilirubin encephalopathy or kernicterus. Screening for jaundice using a transcutaneous bilirubin check or serum bilirubin has contributed tremendously to the reduction of kernicterus, which ranges from 0.5-1.3/100,000 births. Often, the etiology is easy to decipher. Otherwise, it may be complicated when there are several factors contributing. We present a case of a 6-day-old with jaundice and vomiting who was suffering from intestinal malrotation and a urinary tract infection.


1. Shahian M, Rashtian P, Kalani M. Unexplained neonatal jaundice as an early diagnostic sign of urinary tract infection. Int J Infect Dis 2012; 16(7):487-90. doi: 10.1016/j.ijid.2012.02.011.
2. Anderson NB, Calkins KL. Neonatal indirect hyperbilirubinemia. Neoreviews 2020; 21(11):749-60. doi: https://doi.org/10.1542/neo.21-11-e749.
3. Prashanth GP. The significance of enterohepatic circulation in the causation neonatal hyperbilirubinemia. Indian J Pediatr 2012; 79(9):1251-2. doi: 10.1007/s12098-012-0715-y.
4. Garcia FJ, Nager AL. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics 202; 109(5):846-51. doi: 10.1542/peds.109.5.846.
5. Abourazzak S, Bouharrou A, Hida M. Jaundice and urinary tract infection in neonates: simple coincidence or real consequence? Arch Pediatr 2013; 20(9): 974-8. doi: 10.1016/j.arcped.2013.06.005.
6. Steadman S, Ahmed I, McGarry K, et al. Is screening for urine infection in well infants with prolonged jaundice required? Local review and meta-analysis of existing data. Arch Dis Child 2016; 101(7):614-9. doi: 10.1136/archdischild-2015-309265.
7. Tola H, Ranjbaran M, Omani-Samani R, et al. Prevalence of UTI among Iranian infants with prolonged jaundice, and its main causes: systematic review and meta-analysis study. J Pediatr Urol 2018; 14(2):108-115. doi:10.1016/j.jpurol.2018.01.004.
8. Özcan M, Sarici SÜ, Yurdugül Y, et al. Association between early idiopathic neonatal jaundice and urinary tract infections. Clin Med Insights Pediatr 2017;11. doi: 10.1177/1179556517701118.
9. Chen HT, Jeng MJ, Soong, WJ, et al. Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old. J Chin Med Assoc 2011; 74(4):159-63. doi: 10.1016/j.jcma.2011.01.036.
10. Kasap B, Soylu A, Kavukçu S. Relation between hyperbilirubinemia and urinary tract infections in the neonatal period. J Nephrol Ther 2014; 11(01). doi: 10.4172/2161-0959.s11-009.
11. Adams SD, Stanton MP. Malrotation and intestinal atresia. Early Hum Dev 2014; 90(12):921-5. doi: 10.1016/j.earlhumdev.2014.09.017.
12. Shalaby MS, Kuti K, Walker G. Intestinal malrotation and volvulus in infants and children. BMJ 2013; 347:6949. doi: 10.1136/bmj.f6949.
13. Ezer SS, Oguzkurt P, Temiz A, et al. Intestinal malrotation needs immediate consideration and investigation. Pediatr Int 2016; 58(11):1200-04. doi: 10.1111/ped.13075.
14. Porto SO. Jaundice in congenital malrotation of the intestine. Am J Dis Child 1969;117(6):684-688. doi: 10.1001/archpedi.1969.02100030686011.
How to Cite
Okotcha, N., Biggers, A., Martin, J., & Mattamal, R. (2021). A 6-Day-Old Newborn with Vomiting and Jaundice. International Journal of Integrative Pediatrics and Environmental Medicine, 6, 5 - 8. https://doi.org/10.36013/ijipem.v6i.88