Title: Congenital Lobar Overinflation (CLO) presenting as Severe Pneumonia

Authors: Dr Sunil Kumar Agarwalla, Dr Arpita Jalan

 DOI: https://dx.doi.org/10.18535/jmscr/v9i7.08

Abstract

Congenital lobar inflation (CLO) is a rare congenital pulmonary condition with prevalence of 4.5/1,00,000. It accounts for 10% of all congenital lung malformations. This commonly presents as respiratory distress mostly in neonatal period. Congenital alveolar over distension, congenital large hyperlucent lobe, and congenital lobar emphysema are other terms previously used.(1)

Here we present the case of a 4 month old male baby who presented to the Pediatric Emergency Department with severe respiratory distress. Clinically a diagnosis of Pneumonia with Pneumothorax was made but after seeing the X ray which was suggestive of a hyper Lucent, well marginated and delineated cystic shadow occupying left lower lobe, a clinical entity of Pulmonary cyst was made. This was finally diagnosed as a case of Congenital Lobar Inflation of left lower lobe. We are reporting this case because of its rarity where strong clinical suspicion and imaging tools helped in diagnosis and timely intervention.

Keywords: congenital lobar over inflation, congenital lobar emphysema, respiratory distress, pulmonary cyst.

References

  1. Andrade CF, Ferreira HP, Fischer GB. Congenital lung malformations. J Bras Pneumol. 2011;37(2):259‑71. [PubMed] [Google Scholar]
  2. Olutoye OO, Coleman BG, Hubbard AM, Adzick NS. Prenatal diagnosis and management of congenital lobar emphysema. J PediatrSurg. 2000;35(5): 792–795. [PubMed] [Google Scholar]
  3. Nelson RL. Congenital cystic disease of the lung: report of a case. J Pediatr. 1932;1(2):233–238. doi:10.1016/S0022-3476(32)80105-8 [CrossRef] [Google Scholar]
  4. Robertson R, James ES. Congenital lobar emphysema. Pediatrics. 1951;8(6):794–804. [PubMed] [Google Scholar]
  5. Bush A, Harcout J, Hewitt RJ, Nicholson AG. Congenital lung disease In: Wilmott RW, Deterding R, Li A, et al., editors. Kendig’s Disorders of the Respiratory Tract in Children. 9th ed. Philadelphia (PA): Elsevier, Inc; 2019:321–322. [Google Scholar]
  6. Kravitz RM. Congenital malformations of the lung. PediatrClin North Am. 1994; 41(3):453–472. [PubMed] [Google Scholar]
  7. Kaptanoğlu M. Konjenital akciğer hastalıları In: Yüksel M, Kaptanoğlu M, editors. Pediatrik Göğüs Cerrahisi. 1. Baskı ed. Ankara: Turgutyayıncılık; 2004:179–184. [Google Scholar]
  8. Nelson textbook of Pediatrics, 21st
  9. Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: a report from the midwest pediatric surgery consortium. J PediatrSurg. 2019;3468 (19):30184–30188. [PubMed] [Google Scholar]

Corresponding Author

Dr Arpita Jalan

Junior Resident, Department of Paediatrics, M.K.C.G. Medical College & Hospital, Berhampur, Odisha