1116

Recurrent Aspiration Pneumonia Preterm

Figure 1.117. This radiograph is another example of group B streptococcal pneumonia indistinguishable from hyaline membrane disease. Only 50% of blood cultures are positive with congenital pneumonia. The diagnosis of group B streptococcal pneumonia was suggested by a positive tracheal aspirate and urine counterimmune electrophoresis (CIE).

Figure 1.115. Neonatal pneumonia is most commonly caused by group B Streptococcus, but can be due to Escherichia coli, Staphylococcus aureus, or Listeria monocytogenes, etc. Ascending infection and aspiration of infected amniotic fluid is the postulated mechanism of infection. The radiographic appearance of intrauterine pneumonia is very similar to that of meconium aspiration syndrome. There are coarse linear areas of density, segmental areas of consolidation, atelectasis, and air trapping. The lungs are overinflated and, consequently, the diaphragm is at a low position. (Singleton, E., Wagner, M.)

Figure 1.116. This radiograph is an example of group B streptococcal pneumonia. This chest radiograph demonstrates adequate lung expansion, but a diffuse, generalized reticulogranular pattern is noted over the lung fields making die condition difficult to distinguish from hyaline membrane disease.

Figure 1.117. This radiograph is another example of group B streptococcal pneumonia indistinguishable from hyaline membrane disease. Only 50% of blood cultures are positive with congenital pneumonia. The diagnosis of group B streptococcal pneumonia was suggested by a positive tracheal aspirate and urine counterimmune electrophoresis (CIE).

Figure 1.118. In this infant with congenital Listeria monocytogenes pneumonia the radiograph is indistinguishable from other types of pneumonia, but the infant had typical listerial skin lesions at birth and positive blood and spinal fluid cultures.

Figure 1.119. This infant with a birth weight of 700 g developed Staphylococcus aureus osteomyelitis and pneumonia. In this radiograph of the chest, note the consolidation and early pneumatocele formation. There was improvement with antibiotic treatment. At the present time, staphylococcal pneumonia in the neonate is not a major problem. Large outbreaks of staphylococcal infections in nurseries occurred several decades ago, often causing pneumonia and the development of pneumato-celes. Development of air-filled cystic pneumatoce-les is quite characteristic of staphylococcal pneumonia. They generally are a sign of healing and require no specific therapy other than the appropriate antibiotics. Rarely they may rupture into the thorax producing a pneumothorax and the acute onset of distress. This complication suggests that therapy has been inadequate.

Figure 1.120. A chest radiograph of the same infant as in Figure 1.119 shows the pneumatoceles two days later when the infant generally was improving. Fluid levels may occasionally be seen in pneumatoceles. Residual fluid levels presumably represent persistent infection. Pneumatoceles must be differentiated from cystic emphysema which has developed as a sequel to interstitial emphysema or bronchopulmonary dysplasia. The cysts in these conditions are diffuse and bilateral. Serial films demonstrate evidence of prolonged respirator therapy with interstitial emphysema which then pro gresses to emphysematous bullae.

Staph Aureus Pneumonia Pneumatocele

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Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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