Mastitis in neonatal age is an inflammatory process generally caused by an infection of the mammary gland, often sustained by a “Staphylococcus aureus”. It is important to recognize and treat the infection with parenteral antibiotic therapy to avoid possible complications. In case of late diagnosis, inadequate therapy, or abscess, surgical treatment may be necessary. The clinical course of three cases of neonatal mastitis is described here.

Kawasaki disease (KD) still represents a challenge for differential diagnosis because it shares clinical features with other infectious diseases. Adenovirus infection has many symptoms that can be found among the diagnostic criteria of KD. However, the two entities have some minor differences that are useful to distinguish them. It is quite important, even with a positive PCR test for adenovirus, not to exclude a possible KD to avoid a diagnosis delay and possible severe complications.

Hyponatremia is a frequent finding in pediatric emergency department. Association of hyponatremia with hyperkalemia and metabolic acidosis, in a context of urinary tract infection and/or uropathy, may lead to suspicion of secondary pseudohypoaldosteronism (S-PHA). We describe a 8 month old child evaluated for weight loss, severe hyponatremia, mild hyperkalemia and metabolic acidosis. Further evaluation showed elevation in renin and aldosterone concentrations, urinary tract infection and hydroureteronephrosis, suggesting S-PHA diagnosis.

Pediatric acute ataxia generally represents an infrequent occurrence of pediatric emergency department access, but the broad differential diagnosis concerning it requires, starting with anamnesis and objective examination, to mainly exclude life-threatening causes in the child. For these reasons, the diagnosis of acute post infectious cerebellar ataxia, a benign and self-limiting form, which is the underlying cause in most cases of acute ataxia must always be a diagnosis of exclusion. The broad differential diagnosis also requires a correct approach that must consider the setting about the use of imaging techniques proportional to the urgency, in order to reduce the risk of unnecessary radio exposure. Starting from this, we have attempted to summarize the literature regarding the clinical history, physical examination, and diagnostic tests necessary to arrive at a correct diagnosis.

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