Sir.—We read with interest in the Journal (132:167-169, 1978) the report by Rosenstein concerning the occurrence of the meconium plug syndrome (MPS) in three infants who later proved to have cystic fibrosis (CF). The association of MPS and CF was noted to have been previously reported in only one patient.1 The more widely recognized association of MPS has been with Hirschsprung's disease.
We have observed severe MPS in a newborn infant who was found during the neonatal period to have extensive exocrine pancreatic deficiency. Cystic fibrosis was excluded by several sweat chloride tests.
Report of a Case.—At 12 hours of age, an infant (1,840 g, 39 weeks' gestation) began vomiting bile-stained fluid, and at 36 hours of age, developed moderate abdominal distention and passed a 10-cm-long solid meconium plug (first stool) after stimulation with a rectal thermometer. An abdominal roentgenogram showed ileus secondary to organic or mechanical obstruction