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Page 3 / Case 04.03

ANSWER

We considered the following differential diagnosis:
– Infection
– Cardiac anomalies such as partial anomalous pulmonary venous
– Return(PAPVR)/pulmonary vein stenosis
– Congenital anomalies such as pulmonary hypoplasia or aplasia, alveolar capillary
– Dysplasia
– Congenital pleural effusion
– Lymphangiectasia
– Asymmetric surfactant administration or surfacant deficiency
– Interstitial lung disease.

The pregnancy had been complicated by a "cold" 4-5 weeks prior to delivery, for which the mother was given antibiotics. She was known to be GBS negative, VDRL negative, hepatitis B Ag negative and rubella immune.

One week before delivery, she developed an unknown lesion of her perineum, which was swabbed. The result was not available at the time of delivery. Two days after delivery, the result was reported as positive for herpes simplex. The child was transferred to a tertiary care centre and gradually weaned to extubation by 10 days of age. He still maintained his oxygen dependence of 0.2 L of oxygen with a respiratory rate of 50-70 three weeks later.

His chest X-ray remained abnormal and so a CT scan of his chest was performed:

ENLARGE this X-ray (left).

ENLARGE this CT scan(left).
ENLARGE this CT scan(left).
ENLARGE this CT scan(left).

HOW DO YOU INTERPRET THE CT IMAGES?


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