A newborn infant with intrathoracic mass: Questions

Excerpt

A 3,430-g male term newborn was delivered spontaneously to a 25-year-old mother after an uneventful pregnancy and discharged 1 day after birth. The newborn presented with cough and respiratory insufficiency on postnatal day 12, concurrently with upper respiratory tract infection of his older brother. The patient’s physical examination on admission was normal except for wheezing and desaturation. His chest radiograph revealed para-cardiac consolidation (Fig. 1a), and he was admitted to the neonatal intensive care unit (NICU) where he received inhaler salbutamol, oxygen and antibiotic therapy for 10 days. His respiratory signs completely disappeared, but as the consolidate lesion which was observed in the posterior mediastinal region on the right lateral decubitus chest radiography was still present (Fig. 1b) the patient was referred to Level 3 NICU for further evaluation. His physical examination was normal [weight 4,210 g (50th percentile), length 52 cm (25th percentile), head circumference 37 cm (50th percentile) on postnatal day 22], except for diminished ventilation on right lower chest on admission. The blood gas analysis and complete blood count were within normal ranges. Biochemical evaluation for renal and liver function were all normal [Na 139 (normal range 136–146 mEq/L), K 4.4 (normal range 3.5–5.1 mEq/L), blood urea nitrogen 6 (normal range 7–18) mg/dL, creatinine level of 0.18 (normal range 0.6–1.3) mg/dL]. Urine output was measured as 3 mL/kg/h. Echocardiography revealed normal cardiac structure.

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