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Late-onset right-sided diaphragmatic hernia in neonates - case report and review of the literature

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Abstract

An association between early-onset neonatal Group B streptococcal (GBS) sepsis and subsequent diagnosis of late-onset diaphragmatic hernia has been reported. We report one such case and review the literature. The index case involved a male preterm neonate in whom late-onset right diaphragmatic was diagnosed on day 21 following early-onset GBS sepsis. Our literature review identified 40 cases of such an association. The typical description involves near term male neonates, who improved from an early-onset GBS sepsis only to have a secondary respiratory deterioration leading to the diagnosis of late-onset right diaphragmatic hernia. With surgical repair, this condition has an excellent survival rate. In conclusion, the pathophysiological mechanisms underlying the association remain to be elucidated. Awareness of the associated pleural effusion is important to avoid inadvertent organ injury due to chest drains.

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Abbreviations

GBS:

group B streptococcus

CDH:

congenital diaphragmatic hernia

CPAP:

continuous positive airway pressure

N/R:

not reported

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Authors and Affiliations

  1. Department of Neonatal Paediatrics, King Edward Memorial and Princess Margaret Hospitals, Subiaco, Perth, Western Autralia, 6008, Australia

    Tobias Strunk, Karen Simmer & Sanjay Patole

  2. Department of Paediatric Surgery, Women’s and Children’s Health Service, Perth, Western Australia, Australia

    Colin Kikiros

  3. University of Western Australia, Perth, Western Australia, Australia

    Karen Simmer & Sanjay Patole

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  1. Tobias Strunk
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Correspondence to Tobias Strunk.

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Strunk, T., Simmer, K., Kikiros, C. et al. Late-onset right-sided diaphragmatic hernia in neonates - case report and review of the literature. Eur J Pediatr 166, 521–526 (2007). https://doi.org/10.1007/s00431-006-0384-9

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  • DOI: https://doi.org/10.1007/s00431-006-0384-9

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