Bronchopulmonary dysplasia in a premature infant case report and literature review

Abstract

Bronchopulmonary dysplasia is an important cause of morbidity and mortality in premature infants. The aim of this study is to present a premature, extremely low birth weight infant with bronchopulmonary dysplasia. A reviewof the case records of a child with recurrent respiratory distress and the relevant literature. A preterm, extremely low birth weight baby (birth weight was 0.8 Kg), delivered by emergency caesarian section for previous caesarian section and prolonged rupture of fetal membranes at 27 weeks gestational age. She had spontaneous breathing at birth (APGAR scores were 8 in one minute and 10 in 5 minutes). She developed respiratory distress with cyanosis and became oxygen dependent from the second week of life. Examination revealed severe dyspnoea with grunting respiration, tachypnoea, cyanosis and crackles in the lung fields. Chest X-ray showed hyper inf lat ion, r ight lower zone patchy consolidation with obliteration of the costophrenic angle. Echocardiography was however normal. She was successively managed with intermittent oxygen, dexamethasone, salbutamol and antibiotics (ceftriaxone). She was nursed in the incubator for 3 months. There was no episode of apneic attack throughout admission. She responded to treatment and was discharged home on intermittent oxygen therapy and nebulisation. The weight on discharge was 1.6kg. At 6 months of age, she is still having recurrent respiratory distress and supplemental oxygen at home. She is regular to follow up with recurrent episodes of wheeze requiring admissions. Bronchopulmonary dysplasia should be suspected in a premature extremely low birth weight infant with early recurrent respiratory distress.

Key words: Bronchopulmonary dysplasia, prematurity, extreme lowbirth weight.