A rare cause of pneumothorax in a neonate: A case report

Congenital pulmonary airway malformation (CPAM) is a rare developmental lung malformation, typically presenting with respiratory distress in the neonatal period. It is typically diagnosed by fetal ultrasound. We describe a baby boy (22 days old) presenting with respiratory distress. He was admitted at birth for perinatal asphyxia and respiratory distress and was discharged on the 10th day of life. Examination showed severe subcostal retraction with tracheal shift towards the left and reduced breath sounds on the right side of the chest. X-rays of the chest revealed a hyperlucent right lung with a significant mediastinal shift towards the left and compression of the left lung. High-resolution computed tomography (HRCT) of the chest demonstrated a large multicystic lesion almost replacing the right upper and middle lobes, suggestive of CPAM. A lobectomy was planned, but the baby succumbed before surgical intervention. A pathological diagnosis could not be made. CPAM is a rare but significant cause of neonatal respiratory distress, often mimicking conditions like pneumothorax, which can lead to diagnostic challenges. This case underscores the importance of considering CPAM in neonates with persistent respiratory distress and highlights the role of imaging in early diagnosis. Timely recognition and surgical intervention remain crucial to improving outcomes and preventing fatal complications.