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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. 1Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2Division of Neonatal-Perinatal Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3Division 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}sickkids.ca

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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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