The condition of a 3-week-old boy with nasal congestion, tachypnea, and reduced feeding deteriorated, and he underwent intubation and received hemodynamic support in the pediatric ICU.

A 3-week-old boy presented with a 2-day history of nasal congestion, tachypnea, and reduced feeding. He was born at 36 weeks of gestation to a 21-year-old woman (gravida 3, para 1) who had received antenatal treatment for carriage of group B streptococci. He had previously received a 48-hour course of antibiotics for suspected neonatal sepsis because of a fever (temperature, 38.5°C), but the workup for sepsis was negative, and he was discharged home.

Chest Radiographs. On admission of the patient to the emergency department, the temperature was 36.1°C, the pulse 166 beats per minute, the blood pressure 89/63 mm Hg, the respiratory rate 40 breaths per minute, and the oxygen saturation 87% while the patient was breathing ambient air. Chest radiography showed bilateral linear opacities and consolidation in the right upper lobe (Figure 1A). Oxygen and empirical antibiotics (ampicillin and gentamicin) were administered, and the patient was transferred to a pediatric hospital.

 

 

Read more: https://www.nejm.org/doi/full/10.1056/NEJMc2010614