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Clinical Challenge
March 2017

Recurrent Pneumonia in an Infant

Author Affiliations
  • 1University of California, San Diego, School of Medicine, San Diego
  • 2University of California, San Diego, San Diego
  • 3Rady Children's Hospital San Diego, Otolaryngology (ENT), San Diego, California
JAMA Otolaryngol Head Neck Surg. 2017;143(3):307-308. doi:10.1001/jamaoto.2016.2429

A full-term 2719-g female infant was transferred to a neonatal intensive care unit (NICU) on day 1 of life after developing respiratory distress requiring endotracheal intubation. Gestation was complicated by polyhydramnios and gestational diabetes. In the NICU, choking and desaturation were noted with oral feeding. Videofluoroscopic swallow study demonstrated aspiration with all consistencies. Microlaryngoscopy and bronchoscopy were conducted, and the patient was diagnosed as having a type II laryngeal cleft. At 2 weeks of age, she decompensated secondary to Klebsiella pneumoniae sepsis and was intubated for persistent left lung collapse. At that time, computed tomographic (CT) imaging was performed, revealing the etiology of her respiratory decompensation (Figure 1).