Delayed Subaponeurotic Fluid Collection in an Infant Following Instrumental Delivery: A Case Report

We report the case of a 70-day-old male infant who presented with a progressively enlarging, soft, fluctuant swelling over the vertex of the scalp, first noticed on day 43 of life. The infant was born via instrumental vaginal delivery following prolonged labor but had no signs of trauma or scalp swelling at birth. The child remained asymptomatic, with no fever, irritability, or feeding difficulties, and demonstrated normal neurological development. Physical examination revealed a non-tender, fluctuant swelling without overlying skin changes or signs of infection. A thorough differential diagnosis included caput succedaneum, cephalohematoma, subgaleal hemorrhage, and delayed subaponeurotic fluid collection (DSFC). Given the absence of systemic symptoms and neurological deficits, a provisional diagnosis of DSFC was made, and the infant was managed conservatively. The swelling was monitored with scheduled follow-ups, and spontaneous resolution was anticipated. This case emphasizes the importance of recognizing DSFC in the differential diagnosis of scalp swellings in infants and highlights the effectiveness of conservative management in the absence of complications.