Neonatal respiratory distress due to a bronchogenic cyst

A three-month-old Iranian girl was referred to the Johns Hopkins Hospital (JHH) because of increasing respiratory distress. She was a product of a full-term spontaneous vaginal delivery. Antenatal history was normal. The parents were first cousins, as were the mother's parents. It was the third pregnancy; the first ended with spontaneous abortion at three months and the second resulted in an infant who died in the first 24 hours from severe respiratory distress syndrome. The infant did well until six weeks of age when she was noted to have respiratory distress. A chest radiograph at that time showed overinflation of the left lung with mediastinal shift towards the right. The right lung showed patchy radiodensities and loss of volume. She was treated at home with antibiotics and steroids and, although she improved slightly on initial therapy, she was never symptom free. Eventually the symptoms became worse, and she was admitted to a hospital in Iran. When there was no improvement in her condition, she was ...