A right-sided congenital diaphragmatic hernia masked by pneumonia

A 1-day-old premature newborn (34 weeks and 6 days) presented with respiratory insufficiency due to a group B haemolytic streptococcal (GBS) pneumonia. She recovered after temporary treatment with mechanical ventilation and antibiotics. At the time of discharge there was a slight increased fogging o...

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Bibliographic Details
Published inNederlands tijdschrift voor geneeskunde Vol. 152; no. 21; p. 1228
Main Authors Morsing, I E, de Mol, A C, van Heijst, A F J, van der Staak, F H J M, van Daalen, S T H, Liem, K D
Format Journal Article
LanguageDutch
Published Netherlands 24.05.2008
Subjects
Anti-Bacterial Agents - therapeutic use
Female
Hernia, Diaphragmatic - diagnosis
Hernia, Diaphragmatic - surgery
Humans
Infant, Newborn
Pneumonia, Bacterial - diagnosis
Pneumonia, Bacterial - drug therapy
Streptococcal Infections - diagnosis
Streptococcal Infections - drug therapy
Streptococcus agalactiae
Time Factors
Treatment Outcome
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Summary:A 1-day-old premature newborn (34 weeks and 6 days) presented with respiratory insufficiency due to a group B haemolytic streptococcal (GBS) pneumonia. She recovered after temporary treatment with mechanical ventilation and antibiotics. At the time of discharge there was a slight increased fogging on the right side of the chest X-ray, interpreted as residual pleural effusion. Three days later the patient was readmitted with respiratory failure and a need for respiratory support. A chest CT scan revealed a right-sided congenital diaphragmatic hernia (CDH) with a large part of the liver and intestine in the chest. The diaphragmatic defect was closed during a surgical procedure. After an uneventful recovery the patient was discharged in good clinical condition. The combination of delayed presentation of right-sided CDH and neonatal GBS infection occurs rarely but has been described. Its pathogenesis is still unclear.
ISSN:0028-2162