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Miliary pattern in neonatal pneumonia
1Department of Radiology, Hospital da Crianca Santo Antônio, Faculdade Federal de Ciências Médicas, Porto Alegre, Brasil.
Abstract:
We have seen 10 newborn babies who developed respiratory distress and whose chest radiographs showed a miliary nodular pattern of disease. Of these infants only 3 had blood cultures that were positive for staphylococcus aureus. Of the remaining 7, 2 had conjunctivitis from which Staphylococcus aureus was cultured, 4 had negative cultures and 1 did not have a blood culture done. All patients were diagnosed as having bacterial pneumonia and appeared to respond favourably to antibiotic therapy. The pulmonary abnormalities resolved. The children were clinically well in less than 3 weeks. The author suggests that the miliary pattern is one of the radiological patterns of neonatal pneumonia possibly produced by hematogenous bacterial dissemination.
Insights
Neonatal pneumonia can present with a miliary pattern on chest X-rays, even with negative blood cultures. This radiological finding may indicate bacterial dissemination in newborns, responding well to antibiotics.
Area of Science:
- Neonatology
- Pediatric Radiology
- Infectious Diseases
Background:
- Respiratory distress is a common neonatal issue.
- Miliary patterns on chest radiographs can indicate serious lung conditions.
Purpose of the Study:
- To investigate the association between miliary pattern on chest radiographs and neonatal pneumonia.
- To explore the causative agents and diagnostic challenges in these cases.
Main Methods:
- Retrospective review of 10 newborn cases with respiratory distress and miliary pattern on chest radiographs.
- Analysis of blood cultures, conjunctival swabs, and clinical response to antibiotics.
Main Results:
- Only 3 out of 10 infants had positive blood cultures for Staphylococcus aureus.
- Staphylococcus aureus was cultured from conjunctivitis in 2 additional infants.
- All infants were diagnosed with bacterial pneumonia and showed clinical improvement with antibiotics within 3 weeks.
Conclusions:
- The miliary pattern on chest radiographs can be a radiological manifestation of neonatal pneumonia.
- Hematogenous bacterial dissemination is a potential cause of this pattern.
- Prompt antibiotic treatment leads to favorable outcomes in affected neonates.