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Reminder of important clinical lesson
Case report
Premature infant with sudden respiratory distress
  1. Asmaa Elsaudi Nasr1,2,
  2. Alhumaidy Mohamed Alsharaan2 and
  3. Jubara Alallah3
  1. 1Pediatrics-Neonatology, Faculty of Medicine for Girls - Al-Azhar University, Cairo, Egypt
  2. 2Pediatrics-Neonatology, Saudi Arabia Ministry of Health, Aljouf, Sakaka, Saudi Arabia
  3. 3Pediatrics-Neonatology, King Abdulaziz Medical City - Jeddah, Jeddah, Saudi Arabia
  1. Correspondence to Dr Asmaa Elsaudi Nasr; drasmaasaudi{at}yahoo.com

Abstract

Here we describe a case of a premature neonate who showed initial improvement after being on invasive ventilation. She was gradually weaned to room air and was started on a feeding protocol for preterm infants together with total parenteral nutrition through a peripherally inserted central catheter (PICC) when she suddenly deteriorated and developed respiratory distress associated with signs of shock, requiring support from a high-setting mechanical ventilation as well as an inotropic support. A full sepsis work-up was ordered and she was started on antibiotics. The diagnosis was confirmed on chest X-ray and ultrasound, which showed automigration and displacement of the PICC line from its initial site on the left side to the right lung base, causing significant right-side pleural effusion which affected her haemodynamics. The PICC line was removed, and 30 hours later the pleural effusion completely resolved and the patient improved. She was discharged from hospital without any concerns with regard to growth and development during her regular follow-up.

  • neonatal intensive care
  • neonatal and paediatric intensive care
  • neonatal health

https://doi.org/10.1136/bcr-2020-234945

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    Footnotes

    • Contributors JA reviewed the study and gave instructions. AMA planned the study. AEN wrote and submitted the report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer JA, AMA and AEN have disclosed no financial relationships relevant to this article. This report does not contain a discussion of an unapproved/investigative use of a commercial product/device.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.