<![CDATA[Acute scrotal swelling in neonates has various causes, with epididymitis being rare (<1%) and usually related to hematogenous spread from systemic infection. This report describes the clinical presentation, diagnosis, and management of neonatal epididymitis. A 5-day-old male neonate with respiratory distress and jaundice developed fever, tachycardia, and right scrotal swelling. Laboratory findings showed leukocytosis and elevated inflammatory markers. Doppler ultrasound revealed increased vascularity and heterogeneous appearance of the right testis, consistent with epididymitis. The patient was initially treated with ampicillin and gentamicin, later escalated to meropenem and amikacin due to clinical deterioration. Significant improvement followed, with resolution of symptoms after a two-week antibiotic course. Early recognition and appropriate management are essential, and testicular torsion must always be excluded.]]>
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