Rare cause of infantile respiratory distress: A case report of lobar overinflation in a Kenyan neonate

Congenital lobar overinflation (CLO) is a rare non-vascular lung malformation with an incidence of 1:20,000–1:30,000 live births. It presents as respiratory distress in the neonatal period and has associated imaging findings of lobar overinflation. We report a case of a 3-week-old male neonate with respiratory distress and imaging that confirmed right middle lobar over-inflation. Routine fetal ultrasonography should be able to detect these cases; however, they are missed. In Kenya, fetal ultrasonography is not done in most antenatal facilities. CLO presents with respiratory distress, which may be due to infection or compression of the airway with atelectasis of the adjacent lung. Neonates presenting with respiratory distress should have a chest radiograph done to aid in screening and detection of CLO. Surgery for symptomatic cases is preferred as this relieves compression symptoms and provides tissue for confirmatory histologic diagnosis. Surgery also maximizes the chance of a good outcome. Asymptomatic cases may be managed conservatively, but the risk of complications such as recurrent infections, pneumothorax, poor lung development, and malignant transformation remains.