Abstract
A newborn male infant is reported to show the clinical course of tracheoesophageal fistula (TEF) following neonatal toxic shock syndrome-like exanthematous disease (NTED).Necrotizing tracheobronchitis (NTB) is caused by mechanical and/or chemical stimuli such as high concentration oxygen, jet ventilation and endotracheal tube itself, and occurs around the tracheal bifurcation.In contrast, our patient had TEF in the midtrachea, thus, other factors may have played a role in its formation. Case: A male infant, born at 37-week-gestation with uneventful pregnancy and delivery, was admitted to our hospital due to respiratory distress.At six hours of age, endotracheal intubation was performed smoothly.NTED developed at four days of age, and resolved with using antibiotics, catecholamines and anti-DIC agents.When recurrent atelectasis in various bilateral lobes and abdominal distention suddenly appeared at 13 days of age, fiberoptic bronchoscopy and esophagoscopy revealed TEF spreading 2.5cm in length in the midtrachea.He died at 24 days of age despite surgical reconstruction. Although autopsy findings indicated that this fistula was result of NTB, it was located more cranially than those of“traditional”NTB.Other factors such as toxic shock syndrome toxin 1, which causes NTED as a superantigen, may have influenced.
