Infants may present with CAH at birth with ambiguous genitalia or at 1 to 2 weeks of life, with acute adrenal salt wasting crisis. They often have nonspecific symptoms of failure to thrive with poor feeding, lethargy, irritability, and vomiting. Or symptoms may be severe, with dehydration, hypotension, seizures, or even profound shock and may progress to death if not treated. Any neonate presenting with these symptoms should be considered to be in acute adrenal crisis and treated appropriately.