Transient tachypnea of the newborn

Case contributed by Dr Jeremy Jones

Presentation

Respiratory compromise requiring supplemental oxygen. APGARs normal.

Patient Data

Age: Neonate day 0
Gender: Male
X-ray

Bilateral interstitial and airspace opacities. The horizontal fissure is prominent, but there is no significant effusion.

Case Discussion

This is a neonate - there is an umbilical cord clamp projected over the middle of the pelvis. 

You may be tempted to say that you think the child is preterm because of lack of humeral head ossification, but this is the exception that proves the rule - the child was term.

Without an appropriate history, the differential for the film would be wide (e.g. TTN, neonatal pneumonia), or even an atypical RDS or meconium aspiration.

So, with a history of prolonged labour followed by an emergency cesarian section and without features suggestive of sepsis, the differential narrows. The most likely, with these imaging findings, would be TTN and since there was rapid improvement with diuretic therapy and no subsequent chest radiograph was required, this is a reasonable presumptive diagnosis.

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Case information

rID: 23897
Case created: 17th Jul 2013
Last edited: 12th Nov 2017
Systems: Chest, Paediatrics
Inclusion in quiz mode: Included

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