A baby presents with refusal to feed, skin lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is:
Proprionic aciduria
Multiple carboxylase deficiency
Maple syrup urine disease
Urea cycle enzyme deficiency
Baby in the above mentioned case scenario is showing signs and symptoms of multiple carboxylase deficiency such as dermatitis severe metabolic acidosis, organic acid excretion. Ref: Essentials of Pediatrics By Nelson, 16th Edition, Pages 356 ; The Embryo: Scientific Discovery and Medical Ethics By Shraga Blazer, Page 246 ; NORD Guide to Rare Disorders: National Organization for Rare Disorders, Page 483