Right-Sided Bochdalek Hernia Associated with Group B Streptococcal Sepsis in a Preterm Neonate

Abstract

We report here a compelling case of a premature female newborn who was originally treated for breathing difficulties that arose a few hours after delivery. The initial chest radiograph showed no abnormalities, and the blood culture detected sepsis caused by group B streptococcus (GBS). The antibiotic treatment was modified accordingly. Later on, she experienced a gradually increasing opacification in the right side of her chest, which did not respond to medical treatment. A subsequent imaging examination conducted a few days later indicated the presence of a hernia in the right side of the diaphragm. The neonate, who was 14 days old, received surgical intervention to fix the abnormality in the diaphragm. The procedure was successful, and there were no complications during the postpartum period. This case report aims to emphasize the distinctive correlation between early-onset GBS sepsis and the postponed occurrence of right-side diaphragmatic hernia.

Keywords: Bochdalek hernia; Group B streptococcus; neonate.

Figure 1

Initial chest X-ray showing diffuse alveolar densities, reticular opacities and bilateral numerous air bronchograms

Figure 2

Chest X-ray showing diffuse, bilateral, and symmetrical granular opacities without evidence of herniation

Figure 3

Chest X-ray showing a large right-sided diaphragmatic hernia with herniation of bowel contents into right hemithorax)