Shrill cry, opisthotonus, and sun setting sign in a yellow neonate

We report a case of severe neonatal hyperbilirubinaemia (NNH) in a term neonate due to rhesus isoimmunisation resulting in classical clinical features of acute bilirubin encephalopathy and its sequel, kernicterus. Though NNH is common, its complications are less often encountered today with the widespread availability of effective phototherapy. It is important not to miss the clinical signs of this preventable cause of neuro-disability.