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Pathological Case of the Month

Sonya R. Arnold, MD; Orestes Borrego, MD; Enid Gilbert-Barness, MD
Arch Pediatr Adolesc Med. 1996;150(11):1217-1218. doi:10.1001/archpedi.1996.02170360107020.
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A MALE INFANT, weighing 2845 g, was born at 42 weeks' gestation to a 27-year-old, gravida 1, para 0 mother. The pregnancy was complicated by a group B streptococcal infection in the mother. Labor was induced and complicated by fetal distress. The infant was delivered by cesarean section amid thick meconium fluid. A chest x-ray film showed moderate lung disease and small bilateral infiltrates (Figure 1). The infant had multiple neurological symptoms, including a staring gaze, dilated pupils that were unresponsive to light, and lip smacking. There was no response to tactile stimuli, and deep tendon reflexes were absent in all extremities. The infant's condition continued to deteriorate, with a failed response to high-frequency ventilation. Arterial blood gas values were as follows: pH, 6.82; oxygen pressure, 12 mm Hg; carbon dioxide pressure, 98 mm Hg; oxygen saturation, 5%; base excess, −20 mEq/L; and bicarbonate, 10 mEq/L. Extracorporeal membrane oxygenation therapy


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