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Congenital pneumonia — RACP Paediatrics MCQ

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ModerateNeonatalCongenital pneumoniaRACP Paediatrics

A preterm infant (34 weeks) born by emergency caesarean for placental abruption develops respiratory distress and a CXR showing bilateral ground-glass opacities. Blood cultures are pending. Mother had a fever and prolonged ROM (36 hours) before delivery. What is the most likely diagnosis?

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Correct answer: A — Congenital pneumonia

Respiratory distress in a neonate with risk factors for sepsis (maternal fever, prolonged ROM, prematurity) with bilateral ground-glass changes should be treated as congenital pneumonia until proven otherwise. Group B streptococcus is the most common organism. Empirical IV antibiotics (benzylpenicillin + gentamicin) should be commenced immediately.

Reference: RCH Melbourne – 2023 – Neonatal Sepsis CPG