A 6-MONTH-OLD BOY presented with a history of raspy breathing that disappeared when held upright. He had no feeding problems. On physical examination, a mild expiratory wheeze and a grade ¾ systolic heart murmur were heard at his back. A chest radiograph was obtained (Figure 1).
The infant was born at 31 weeks' gestational age weighing 1213 g. He required a short course of respiratory assistance, and an umbilical artery catheter was used for the first 5 days. The hospital course was complicated on day 5 by Staphylococcus aureus sepsis and osteomyelitis of the left femur, ischium, and tibia. Purulent fluid was present at the umbilical stump. An echocardiogram showed no abnormalities. Further imaging evaluation included a contrast-enhanced computed tomographic scan (Figure 2) and a magnetic resonance image of the thorax (Figure 3).
Long DE, Long FR, Seguin J. Radiological Case of the Month. Arch Pediatr Adolesc Med. 1999;153(11):1195-1196. doi:10.1001/archpedi.153.11.1195