Acute neonatal scalp abscess and E coli bacteremia in the ED

An atypical presentation of newborn scalp abscess is described in a 9-day-old infant. The infant appeared nontoxic upon presentation on day 9 after birth with a scalp abscess and Escherichia coli bacteremia. The infant had been admitted from the emergency department to the newborn intensive care unit on day 4 after birth with the same diagnosis; however, she was discharged within hours without treatment. This case report demonstrates the subtle clinical features, presentation, microbiology, and appropriate emergency department management of neonatal scalp abscesses.