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Group B streptococcal sepsis and congenital diaphragmatic hernia: do not overlook normal initial imaging studies!
  1. Hossam Elshafei1,
  2. Mohamed Ibrahim2,3,
  3. Louise Montalva1,
  4. Sally Machaly2,3,
  5. Jennifer Young3,
  6. Augusto Zani1
  1. 1 Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2 Division of Neonatal-Perinatal Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3 Division of Neonatal-Perinatal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
  1. Correspondence to Professor Augusto Zani, Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; augusto.zani{at}

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A term female infant, born after an uneventful pregnancy with normal antenatal ultrasonography, presented at 2 hours of life with respiratory distress, requiring mechanical ventilation. Her initial chest X-ray was unremarkable (figure 1A). The blood culture at birth was positive for group B streptococcus (GBS). She improved with antibiotics, allowing extubation to continuous positive airway pressure (CPAP) on day-of-life (DOL)-4. Weaning from CPAP failed on several occasions. An ultrasound (DOL-19) showed normal function of both hemidiaphragms, but a chest X-ray showed right lung hyperdensity with pleural effusion (figure …

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  • HE and MI contributed equally.

  • Contributors All authors have made a substantial contribution in the development of this paper and have agreed to the submission of this manuscript in its present form.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.