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Case 123 

Case 123
Chapter:
Case 123
Author(s):

Ellen Chung

DOI:
10.1093/med/9780199758968.003.0123
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date: 16 February 2019

Newborn with respiratory distress.

AP radiograph demonstrates hyperinflated lungs, coarse increased markings, and right pleural fluid (arrowheads).

Bilateral symmetric findings suggest medical lung disease as opposed to surgical entities such as diaphragmatic hernia or congenital lung malformation. The differential diagnosis depends on whether the infant is term or preterm. For a preterm infant, the diagnosis is usually surfactant deficiency disease. For a term infant, the differential diagnosis includes transient tachypnea of the newborn (TTN) and neonatal pneumonia. TTN causes mild to moderate respiratory distress and resolves within 48 to 72 hours. Predisposing factors include cesarean section and precipitous delivery in which there is no thoracic squeeze to expel fetal lung fluid. Findings of hyperinflation and coarse markings favor meconium aspiration....

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