eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Neonatology

Congenital Pneumonia: Multimedia

Author: Roger G Faix, MD, Professor, Department of Pediatrics (Neonatology), University of Utah School of Medicine
Contributor Information and Disclosures

Updated: Oct 5, 2009

Multimedia

Anteroposterior chest radiograph in an infant bor...
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Media file 1: Anteroposterior chest radiograph in an infant born at 28 weeks' gestation was performed following apnea and profound birth depression. Subtle reticulogranularity and prominent distal air bronchograms were consistent with respiratory distress syndrome, prompting exogenous surfactant and antimicrobial therapy.

Initial smear of endotracheal aspirate revealed few neutrophils but numerous, small, gram-negative coccobacilli. Culture of blood and tracheal aspirate yielded florid growth of nontypeable Haemophilus influenzae.
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Anteroposterior chest radiograph in an infant bor...

Anteroposterior chest radiograph in an infant born at 28 weeks' gestation was performed following apnea and profound birth depression. Subtle reticulogranularity and prominent distal air bronchograms were consistent with respiratory distress syndrome, prompting exogenous surfactant and antimicrobial therapy.

Initial smear of endotracheal aspirate revealed few neutrophils but numerous, small, gram-negative coccobacilli. Culture of blood and tracheal aspirate yielded florid growth of nontypeable Haemophilus influenzae.

Full-term infant (note ossified proximal humeral ...
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Media file 2: Full-term infant (note ossified proximal humeral epiphyses, consistent with full term) with progressive respiratory distress from birth following delivery to a febrile mother through thick, particulate, meconium-containing fluid and recovery of copious meconium from the trachea. Right clavicle is fractured without displacement.

Note the coarse dense infiltrates obscuring the cardiothymic silhouette bilaterally with superimposed prominent air bronchograms. Listeria monocytogenes was recovered from the initial blood culture.
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Full-term infant (note ossified proximal humeral ...

Full-term infant (note ossified proximal humeral epiphyses, consistent with full term) with progressive respiratory distress from birth following delivery to a febrile mother through thick, particulate, meconium-containing fluid and recovery of copious meconium from the trachea. Right clavicle is fractured without displacement.

Note the coarse dense infiltrates obscuring the cardiothymic silhouette bilaterally with superimposed prominent air bronchograms. Listeria monocytogenes was recovered from the initial blood culture.

Patchy infiltrates most prominent along left card...
(Enlarge Image)
Media file 3: Patchy infiltrates most prominent along left cardiothymic margin in a full-term infant (note proximal humeral ossific nuclei) born to an afebrile woman 18 hours after membranes ruptured. The infant was initially vigorous but developed gradual onset of progressive respiratory distress beginning at 2 hours and prompting endotracheal intubation and transfer to a tertiary center at age 10 hours.

Note blunting of the right costophrenic angle, a thin radiodense rim along the lateral right hemithorax, and a fluid line in the right major fissure, all consistent with pleural effusion. Gram staining of pleural fluid recovered at thoracentesis indicated occasional gram-negative bacilli.

Tracheal aspirate, pleural fluid, and blood all yielded Escherichia coli upon culture. The dense right upper lobe may appear to suggest lobar infiltrate, but upward bowing of the fissure is more suggestive of volume loss, as in atelectasis, than the bulging picture expected with dense pneumonic change. This lobe appeared normal and appropriately inflated on a subsequent film 2 hours later, also suggestive of atelectasis. Umbilical venous catheter and endotracheal tube were positioned properly on the follow-up film.
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Patchy infiltrates most prominent along left card...

Patchy infiltrates most prominent along left cardiothymic margin in a full-term infant (note proximal humeral ossific nuclei) born to an afebrile woman 18 hours after membranes ruptured. The infant was initially vigorous but developed gradual onset of progressive respiratory distress beginning at 2 hours and prompting endotracheal intubation and transfer to a tertiary center at age 10 hours.

Note blunting of the right costophrenic angle, a thin radiodense rim along the lateral right hemithorax, and a fluid line in the right major fissure, all consistent with pleural effusion. Gram staining of pleural fluid recovered at thoracentesis indicated occasional gram-negative bacilli.

Tracheal aspirate, pleural fluid, and blood all yielded Escherichia coli upon culture. The dense right upper lobe may appear to suggest lobar infiltrate, but upward bowing of the fissure is more suggestive of volume loss, as in atelectasis, than the bulging picture expected with dense pneumonic change. This lobe appeared normal and appropriately inflated on a subsequent film 2 hours later, also suggestive of atelectasis. Umbilical venous catheter and endotracheal tube were positioned properly on the follow-up film.

More on Congenital Pneumonia

Overview: Congenital Pneumonia
Differential Diagnoses & Workup: Congenital Pneumonia
Treatment & Medication: Congenital Pneumonia
Follow-up: Congenital Pneumonia
Multimedia: Congenital Pneumonia
References
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Further Reading

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Keywords

congenital pneumonia, congenital pneumonitis, neonatal pneumonia, neonatal pneumonitis, pulmonary infection, lung infection, maternal chorioamnionitis, prematurity, meconium in the amniotic fluid, unexplained preterm labor, membrane rupture, uterine tenderness, maternal genitourinary tract infection, fetal tachycardia, congestive heart failure, congenital structural heart disease, hemoglobinopathy, polycythemia, pulmonary hypertension, jaundice, abdominal distention, oliguria, conjunctivitis, vesicles, erythema, hepatomegaly, true congenital pneumonia, intrapartum pneumonia, postnatal pneumonia, treatment, diagnosis

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Contributor Information and Disclosures

Author

Roger G Faix, MD, Professor, Department of Pediatrics (Neonatology), University of Utah School of Medicine
Roger G Faix, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, American Society for Microbiology, National Perinatal Association, Society for Pediatric Research, and Utah Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Steven M Donn, MD, Professor of Pediatrics, University of Michigan Medical School; Director, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan Health System
Steven M Donn, MD is a member of the following medical societies: American Pediatric Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Brian S Carter, MD, FAAP, Professor of Pediatrics (Neonatology), Vanderbilt University School of Medicine; Co-director, Pediatric Advance Comfort Team, Monroe Carell Jr Children's Hospital at Vanderbilt
Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Society for Bioethics and Humanities, American Society of Law Medicine and Ethics, National Hospice and Palliative Care Organization, and Southern Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Carol L Wagner, MD, Professor of Pediatrics, Medical University of South Carolina
Carol L Wagner, MD is a member of the following medical societies: American Academy of Pediatrics, American Chemical Society, American Medical Women's Association, American Public Health Association, American Society for Bone and Mineral Research, American Society for Clinical Nutrition, Massachusetts Medical Society, National Perinatal Association, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD, Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine
Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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