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

Approach to DDX 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