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Development of Localized Pulmonary Interstitial Emphysema in a Late Preterm Infant without Mechanical Ventilation

Pritish Bawa1, Kultida Soontarapornchai2, Agnes Perenyi2

  • 1Department of Radiology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

Case Reports in Pediatrics
|April 19, 2014
PubMed

Insights

Pulmonary interstitial emphysema (PIE) can occur in premature infants even without mechanical ventilation. This case highlights conservative management of PIE and pneumothorax in a neonate on CPAP, leading to recovery.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Medical Imaging

Background:

  • Pulmonary interstitial emphysema (PIE) is a known complication in premature infants requiring mechanical ventilation.
  • PIE has been documented in neonates receiving less intensive respiratory support, including continuous positive end-expiratory pressure (CPAP).

Purpose of the Study:

  • To report a case of PIE and spontaneous pneumothorax (PTX) in a premature neonate receiving only CPAP.
  • To emphasize that PIE can develop independently of mechanical ventilation.
  • To describe imaging findings, pathogenesis, and differential diagnoses of PIE.

Main Methods:

  • Case report of a premature neonate with respiratory distress.
  • Utilized plain film and computed tomography (CT) for diagnosis.
  • Managed conservatively without surgical intervention.

Main Results:

  • The neonate developed PIE and PTX while on CPAP therapy.
  • Conservative treatment led to radiological resolution and clinical improvement.
  • No surgical intervention was necessary.

Conclusions:

  • PIE can occur in premature infants without mechanical ventilation, even with CPAP support alone.
  • Conservative management can be effective for PIE and associated PTX in neonates.
  • This case expands the understanding of PIE development and management in neonates.

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