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Severe dehydration, especially if struggling with breastfeeding, renal failure and electrolyte imbalance, and neurological and cardiorespiratory failure may result. This late preterm was born healthy during a heatwave and developed lethargy and minimal responsiveness from day of life (DOL) 5, developed seizures at DOL 12, then demised at DOL 20. All hospitals involved in the diagnostic workup and treatment presumed severe sepsis and treated accordingly. However, microbiology results were always negative. In infants, especially if preterm, it is challenging to distinguish septic shock from heat-related illness, as well as other neonatal diagnoses. Medical history, including risk factors for infection and heat-related disease, must be thoroughly explored. It is important for healthcare workers and the public to be aware of potentially fatal neonatal heat-related illness.<\/jats:p>","DOI":"10.1136\/bcr-2025-265923","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:20:30Z","timestamp":1759900830000},"page":"e265923","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Awareness of neonatal heat illness: a fatal outcome in a late preterm infant"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5746-3717","authenticated-orcid":false,"given":"Britt","family":"Nakstad","sequence":"first","affiliation":[{"name":"Department Paediatrics and Adolescent Health, University of Botswana Faculty of Medicine, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mbali","family":"Mogomotsi-Pilane","sequence":"additional","affiliation":[{"name":"Department Paediatrics and Adolescent Health, University of Botswana Faculty of Medicine, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Lee","family":"Solev\u00e5g","sequence":"additional","affiliation":[{"name":"Neonatal Department, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway"},{"name":"Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Lusambili","sequence":"additional","affiliation":[{"name":"Africa International University, Nairobi, Nairobi County, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"2025100722201441000_18.10.e265923.1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2012.11"},{"key":"2025100722201441000_18.10.e265923.2","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.930348","article-title":"A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries","volume":"10","author":"Edney","year":"2022","journal-title":"Front Pediatr"},{"key":"2025100722201441000_18.10.e265923.3","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1159\/000525573","article-title":"How Climate Change May Threaten Progress in Neonatal Health in the African Region","volume":"119","author":"Nakstad","year":"2022","journal-title":"Neonatology"},{"key":"2025100722201441000_18.10.e265923.4","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00484-013-0655-x","article-title":"The impact of heat waves on children\u2019s health: a systematic review","volume":"58","author":"Xu","year":"2014","journal-title":"Int J Biometeorol"},{"key":"2025100722201441000_18.10.e265923.5","doi-asserted-by":"crossref","DOI":"10.3390\/nu11092010","article-title":"Pediatric Thermoregulation: Considerations in the Face of Global Climate Change","volume":"11","author":"Smith","year":"2019","journal-title":"Nutrients"},{"key":"2025100722201441000_18.10.e265923.6","first-page":"E556","article-title":"Risk factors associated with serious bacterial infections among newborns with high body temperature","volume":"61","author":"Naseh","year":"2020","journal-title":"J Prev Med Hyg"},{"key":"2025100722201441000_18.10.e265923.7","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13841215"},{"key":"2025100722201441000_18.10.e265923.8","doi-asserted-by":"crossref","first-page":"151837","DOI":"10.1016\/j.semperi.2023.151837","article-title":"Pregnancy and newborn health - 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