Last update:
24-May-2026

We describe the diagnostic challenges, surgical management strategies, and postoperative complications in an infant with congenital lobar emphysema (CLE). A 3-month-old female infant was brought to the hospital with progressive tachypnea, chest retractions, cyanosis, and feeding difficulties that resulted in failure to thrive. Initially, the patient was diagnosed with pneumonia and received intravenous antibiotics. Subsequently, chest radiography was misinterpreted as pneumothorax, leading to chest tube placement without clinical improvement. Further evaluation with chest computed tomography (CT) revealed hyperinflation of the left upper lobe, mediastinal shift, and compression of the surrounding lung tissue, establishing the diagnosis of CLE. The patient underwent left upper lobectomy, which immediately improved oxygen saturation. Postoperatively, the patient developed ventilatorassociated pneumonia, sepsis caused by multidrug-resistant Acinetobacter baumannii, and persistent malnutrition, which were managed with last-line antibiotics, high-calorie enteral nutrition, and chest physiotherapy. In conclusion, this case highlights the importance of clinical vigilance for CLE in neonates with respiratory distress unresponsive to conventional therapy. Lobectomy is effective as a definitive treatment; however, optimal recovery requires multidisciplinary management, particularly infection prevention and nutritional rehabilitation.

Key words: Congenital lobar emphysema, Infant newborn, Lobectomy, Malnutrition, Nosocomial infections, Respiratory distress syndrome newborn.