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A 1-week-old baby presented to the accident and emergency department following a collapse at home, where he had become grey and floppy with shallow breathing.
He had been delivered vaginally at term and there were no known risk factors for sepsis. The baby’s mother was not known to carry Group B Streptococcus.
On presentation, he was profoundly acidotic. A chest radiograph was performed. The baby was intubated and ventilated and transferred to intensive care.
Treatment for sepsis was commenced with intravenous antibiotics and aciclovir. Cultures and viral PCRs subsequently proved negative. Echocardiography demonstrated normal cardiac anatomy and function, with a small patent ductus arteriosus.
The baby improved sufficiently to allow extubation but he remained tachypnoeic and dependent on high-flow oxygen. A repeat chest radiograph showed persistent abnormalities (figure 1).
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