Panniculitis Masquerading as Generalised Lymphadenopathy in a Neonate: A Diagnostic Dilemma – A Case Report

Panniculitis Masquerading as Generalised Lymphadenopathy in a Neonate: A Diagnostic Dilemma – A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Panniculitis Masquerading as Generalised Lymphadenopathy in a Neonate: A Diagnostic Dilemma – A Case Report Michael Abel Alao, Mustapha Akanji Ajani, Olufisayo Christopher Ologunore, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7180423/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 14 You are reading this latest preprint version Abstract Background: Generalised lymphadenopathy is rare in neonates and often suggests a serious systemic illness, including malignancy or congenital infection. Panniculitis is not commonly considered as a differential diagnosis in this age group. This case report highlights the diagnostic dilemma posed by panniculitis presenting as generalised lymphadenopathy in a neonate. Case Presentation: A late preterm male infant presented with respiratory distress and cyanosis, and by the 11th day of life, developed multiple firm, tender nodular swellings over the neck, axillae, epigastrium, groin, and trunk, initially presumed to be generalized lymphadenopathy. He had a history of birth asphyxia and a family history of childhood deaths. He was managed for neonatal sepsis. DNA PCR confirmed congenital cytomegalovirus (CMV) infection, and histology revealed panniculitis. Treatment included broad-spectrum antibiotics, respiratory support via CPAP, and oral ganciclovir. He showed clinical improvement and was discharged in stable condition with multidisciplinary follow-up arranged. Conclusion Panniculitis presenting as generalised lymphadenopathy is unusual finding in neonates. Early biopsy and histopathological confirmation are essential in avoiding misdiagnosis. Panniculitis Generalised Lymphadenopathy Neonate CMV infection Case report Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Sep, 2025 Reviews received at journal 24 Sep, 2025 Reviewers agreed at journal 21 Sep, 2025 Reviewers agreed at journal 19 Sep, 2025 Reviews received at journal 30 Aug, 2025 Reviewers agreed at journal 30 Aug, 2025 Reviews received at journal 30 Aug, 2025 Reviewers agreed at journal 29 Aug, 2025 Reviewers agreed at journal 24 Aug, 2025 Reviewers invited by journal 22 Aug, 2025 Editor invited by journal 01 Aug, 2025 Editor assigned by journal 01 Aug, 2025 Submission checks completed at journal 01 Aug, 2025 First submitted to journal 21 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7180423","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":491180995,"identity":"e40f2fba-31df-4004-9bf1-311ee4673afe","order_by":0,"name":"Michael Abel 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Panniculitis, Generalised Lymphadenopathy, Neonate, CMV infection, Case report","lastPublishedDoi":"10.21203/rs.3.rs-7180423/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7180423/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGeneralised lymphadenopathy is rare in neonates and often suggests a serious systemic illness, including malignancy or congenital infection. Panniculitis is not commonly considered as a differential diagnosis in this age group. This case report highlights the diagnostic dilemma posed by panniculitis presenting as generalised lymphadenopathy in a neonate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase Presentation:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA late preterm male infant presented with respiratory distress and cyanosis, and by the 11th day of life, developed multiple firm, tender nodular swellings over the neck, axillae, epigastrium, groin, and trunk, initially presumed to be generalized lymphadenopathy. He had a history of birth asphyxia and a family history of childhood deaths. He was managed for neonatal sepsis. DNA PCR confirmed congenital cytomegalovirus (CMV) infection, and histology revealed panniculitis. Treatment included broad-spectrum antibiotics, respiratory support via CPAP, and oral ganciclovir. 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Early biopsy and histopathological confirmation are essential in avoiding misdiagnosis.\u003c/p\u003e","manuscriptTitle":"Panniculitis Masquerading as Generalised Lymphadenopathy in a Neonate: A Diagnostic Dilemma – A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-28 05:34:56","doi":"10.21203/rs.3.rs-7180423/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-30T16:18:29+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-24T14:31:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110026206191928200297250845589356254029","date":"2025-09-21T09:02:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"106253074537560326829619364197994992423","date":"2025-09-20T01:25:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-30T14:58:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44186436614399300864159532806825673643","date":"2025-08-30T14:43:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-30T07:55:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219990841808089599907218810914903686411","date":"2025-08-30T03:49:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"216892475665472900555179414621382539780","date":"2025-08-24T17:07:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-22T12:48:06+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-01T15:31:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-01T14:13:49+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-01T14:12:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-07-21T19:08:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c4e90f7b-2d1a-4f64-a16c-8dc8bd388188","owner":[],"postedDate":"July 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-01T21:38:11+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-28 05:34:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7180423","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7180423","identity":"rs-7180423","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}