Can you diagnose this infant with neonatal respiratory distress?
A recently immigrated mother from India presents in preterm labor at 32 6/7 weeks and delivers a vigorous baby whose initial blood culture result is positive at 18 hours of life with gram-negative rods.
Can you diagnose this infant with neonatal respiratory distress? | Image credit: Contemporary Pediatrics
The Case
At 32 6/7 weeks, a 1970-g child was born via meconium-stained vaginal delivery to a 37-year-old mother (gravida 2, para 1) who recently immigrated from India. The mother presented with preterm premature rupture of membranes for 11 hours prior to eventual vaginal delivery.
Maternal history was otherwise notable for rubella nonimmunity, advanced maternal age, and a prior history of intrauterine fetal death 4 years prior. Prior to delivery, the mother received one dose of ampicillin given her unknown group B Streptococcus status and a single dose of betamethasone to accelerate fetal lung maturity.
After delivery, the newborn was vigorous, with delayed cord clamping of 1 minute. The Apgar scores were 8 and 8 at 1 and 5 minutes of life, respectively. There was mildly increased respiratory effort in the delivery room, for which continuous positive airway pressure (CPAP) respiratory support was begun. The child was brought to the neonatal intensive care unit with CPAP of 5 and 30% fraction of inspired oxygen.
Below, take your best guess at diagnosing this patient.
What is the diagnosis of this case, based on the information provided?
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