Differential diagnosis of respiratory distress in neonate (pre-term or term) – medical causes

• Respiratory distress syndrome
• Transient tachypnea of the newborn
• Meconium aspiration syndrome
• Group B streptococcus pneumonia

Approach to differential diagnosis of medical causes of respiratory distress in the neonate (pre-term or term):

• In pre-term infants, respiratory distress syndrome (hyaline membrane disease, surfactant deficiency disorder) is the main cause of respiratory distress with its low lung volumes and ground glass appearance
• Respiratory distress syndrome can also rarely be seen in term infants with respiratory distress
• Transient tachypnea of the newborn has normal lung volumes and prominent fine interstitial infiltrates with +/- pleural effusion which resolve within 1-2 days
• Group B strep pneumonia has normal lung volumes and streaky fine infiltrates with +/- pleural effusion and cannot initially be differentiated radiographically from transient tachypnea of the newborn
• Meconium aspiration syndrome has increased lung volumes and coarse, ropey interstitial infiltrates