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Abstract: The child, female, was delivered at term, with degree I amniotic fluid contamination, 1 hour after birth, with respiratory symptoms such as shortness of breath and weak positive trismus sign.
Basic information】Female, 2 hours newborn
Disease Type】Congenital pneumonia
Hospital】Jinan Children’s Hospital
Date of consultation】June 2022
Treatment plan】Oxygen therapy + non-invasive ventilator support therapy + medication (Ceftriaxone sodium for injection, budesonide suspension for inhalation)
[Treatment period] Hospitalization for 10 days
Treatment effect] Clinical symptoms disappeared and the disease was cured
I. Initial consultation
The baby was delivered at term, 2 hours old, with normal placenta and umbilical cord, and amniotic fluid I degree contamination, and developed shortness of breath about 1 hour after birth, with weak positive trismus sign. The shortness of breath was obvious, with 70 breaths/min, accompanied by foamy mouth and slightly bruised extremities; the respiratory sounds were coarse on auscultation; pulse oxygen was monitored at 88%. The child’s chest X-ray showed increased texture in both lungs with patchy changes supporting congenital pneumonia, while the cardiac ultrasound showed no abnormalities.
(Chest X-ray)
II. Treatment history
Immediately after admission to our department, the child was given non-invasive ventilator support (CPAP) to provide airway pressure, oxygen therapy to improve the child’s respiratory status, and ceftriaxone sodium for injection to reduce the symptoms of pulmonary infection, and budesonide suspension for inhalation to reduce the airway inflammatory response. As the treatment was effective, the parameters of noninvasive ventilator support were gradually reduced, and noninvasive ventilator support was withdrawn and replaced by oxygen therapy on the third day of admission. During the application of non-invasive ventilator support, oral milk was given to enhance nutritional support and ensure adequate caloric intake.
III. Treatment effect
After the child was admitted to the neonatal ward, after active ventilator support treatment, anti-infection treatment and symptomatic support, the symptoms of shortness of breath gradually improved, the peripheral circulation function improved, the skin mucous membrane color turned red and moist, and the pulse oxygen monitoring was maintained at about 93%. On the 10th day of the treatment course, the child’s infection index was normal on re-examination, respiration was stable, body temperature was normal, feeding was normal, and the respiratory sounds of both lungs were normal on auscultation, so the antibiotics were stopped and the child was discharged.
IV. Notes
We are glad to see that the child has turned to safety after the relevant treatment. After the child is discharged from the hospital, the family should pay attention to keeping the air in the room clean and fresh, with appropriate temperature and humidity, avoiding the child from getting cold or overheating, and avoiding the child’s contact with people suffering from cold and other diseases. Breastfeeding is recommended, and if complementary foods have been added, they should be light and nutritious. If the child becomes unwell, he/she should be sent to the doctor immediately to avoid delaying treatment.
V. Personal insight
Congenital pneumonia is a lung infection due to intrauterine infection. This child has a history of amniotic fluid contamination, and fecal-stained amniotic fluid entering the respiratory tract can lead to respiratory infection. When parents find that their newborn has lung infection, such as fever, shortness of breath, cough, phlegm in the throat, and foamy mouth, they need to seek medical treatment in a timely manner. As in the case of this patient, professional in-hospital treatment + careful home care resulted in good treatment and gradual recovery of the child.