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Localized persistent pulmonary interstitial emphysema in a preterm infant in the absence of mechanical ventilation

David R Berk1, Laura J Varich

  • 1Division of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA 94305-5105, USA.

Pediatric Radiology
|August 9, 2005
PubMed

Insights

Localized persistent pulmonary interstitial emphysema is rare in preterm infants without ventilation. Radiologists should consider this diagnosis in preterm infants with cystic lung lesions, even without mechanical ventilation, to avoid misdiagnosis and unnecessary surgery.

Area of Science:

  • Neonatal Medicine
  • Pediatric Radiology
  • Pulmonology

Background:

  • Localized persistent pulmonary interstitial emphysema (LPPIE) is a rare condition in preterm infants.
  • It is typically associated with mechanical ventilation or continuous positive airway pressure (CPAP).
  • The rarity of LPPIE in the absence of respiratory support can lead to diagnostic challenges.

Observation:

  • A preterm infant presented with respiratory distress on the first day of life.
  • Radiographic findings suggested pulmonary interstitial emphysema.
  • The infant had not yet received CPAP or mechanical ventilation.

Findings:

  • The case highlights the occurrence of LPPIE in a preterm infant prior to respiratory support.
  • This presentation challenges the conventional association of LPPIE with positive pressure ventilation.
  • CT imaging can aid in differentiating LPPIE from other cystic lung lesions.

Implications:

  • Radiologists must consider LPPIE in the differential diagnosis of cystic lung lesions in preterm infants, irrespective of ventilation status.
  • Early and accurate diagnosis of LPPIE can prevent unnecessary surgical interventions.
  • Timely diagnosis can reduce the morbidity and mortality associated with misdiagnosis and delayed treatment in neonates.

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