CT's Role in Diagnosing Neonatal Pneumonia
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Catalin PelinCT's Role in Diagnosing Neonatal Pneumonia
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Catalin PelinROLE OF COMPUTERIZED TOMOGRAPHY IN
THE DIAGNOSTIC OF NEONATAL PNEUMONIA
V. Ștefănescu1, A.M. Pelin¹, S. Gherghe1, S. Hilohi1, A.M. Bratu²,
S. Fotea1, A. Nechita1, G. Baciu1, C. Zaharia2
1 Faculty of Medicine and Pharmacy, Dunărea de Jos University of Galați, România,
2 Carol Davila University of Medicine and Pharmacy of Bucharest, România
Introduction
The passage from the uterine to the external environment requires multiple physiological, respiratory and
haemodynamic modifications for the new-born’s successful adaptation. Throughout this adaptation a series of
disorders might occur, such as the respiratory distress syndrome, new-born’s transitory tachypnoea, the
meconium aspiration syndrome and pneumonia. Respiratory disorder is one of the common manifestations due
to which the new-born is admitted to the ICU. Despite the neonatal intensive therapy progresses, respiratory
disorders remain an important cause of mortality and morbidity in the new-born. The early acknowledgement of
the respiratory distress and the initiation of adequate treatment are paramount to ensuring optimum results.
Materials and method
A descriptive, retrospective study was conducted on all the patients diagnosed with respiratory distress such as
bronchopneumonia or pneumonia, age ranging from 1-28 days, admitted to the neonatology section of Sfântul Ioan
Infant Emergency Clinical Hospital Galați, on a 3-years period, who required thoracic CT for diagnostic confirmation.
Results
A 15-day-old girl with fever which chest X-ray reveals right
upper lobe opacity; CT scan shows consolidation with air
bronchogram in the same territory.
A 15-day-old boy with respiratory distress syndrome; chest X-ray reveals
bilateral diffuse perihilar consolidations; Chest CT scan shows bilateral
“ground glass’’ opacities with air-bronchogram on the right side.
A 2-day-old premature boy with sepsis, thoraco-abdominal X-ray reveals bilateral pneumothorax more on the left side and
abdominal air-fluid levels; CT scan reveals bilateral pneumothorax, a right lower lobe consolidation, a left lower lobe collapse due to
pneumothorax and meconium peritonitis with dilated bowel loops, intraperitoneal calcification and free fluid in the abdomen.
Conclusions: Despite the neonatology progresses, neonatal
pneumonia remains a serious issue even in the developed
countries, mainly due to the possible complications. In most
cases included in the study, it was the pulmonary X-ray that
established the diagnostic, other imagery investigations being
unnecessary. Yet there were circumstances when the X-ray could
not reveal small-size pneumonia foci, sometimes mistaken with
A 5-day-old boy with fever and dyspnoea; chest X-ray the thymus or other localizations that were hard to see on the X-
reveals right perihilar consolidation and possible
pneumothorax on the right side, in the mediastinal
ray and, not lastly, affections having a major clinical impact; it was
pleura; Chest CT scan shows small pneumothorax and the CT that revealed them and exactly specified the extent of the
bilateral consolidations. congestive nidus.