Primary pulmonary hypoplasia masquerading as pneumonia in a preterm neonate and creating a diagnostic challenge: a case report

Given the rarity of primary pulmonary hypoplasia, this condition is often missed by pediatricians, leading to injudicious use of antibiotics and failure to correctly inform the parents about the condition. This case underscores the need for early computed tomography imaging in preterm neonates with unexplained respiratory failure to differentiate hypoplasia from infections, mitigate futile treatments, and guide parental counseling. Clinical features, a negative sepsis workup, and nonresponse to antibiotics can provide clues to diagnosing pulmonary hypoplasia. Simple bedside investigations, such as chest radiographs, should be heavily relied upon, especially in resource-poor settings.