A newborn with a genital prolapse.

DESCRIPTION We describe a 3-week-old girl with a genital prolapse. She was seen postnatally because a prenatal ultrasound had shown a cystic dilation in the right kidney. Ultrasound showed two duplex kidneys, with hydronephrosis of the upper pole of the right kidney and a ureterocele in the bladder. Antibiotic prophylaxis was started while further investigations were awaited. At 3 weeks of age the patient presented to the emergency department with fever. Physical examination showed a moderately ill girl, with no obvious signs to explain the origin of the fever. Genital examination showed a blue cystic mass extruding from the vulva,most likely a ureterocele (figure 1). Urine culturewas positive for Klebsiella oxytoca. Dimercaptosuccinic acidscintigraphy showed an almost non-functioning upper pole of the right kidney. The patient was treated with intravenous antibiotics and made a good recovery. Voiding cystogram showed right-sided vesicoureteral reflux grade one to the lower pole.