A case of an infant with Down syndrome presenting with recurrent respiratory symptoms after birth in which tracheal bronchus was detected by chest CT

Abstract

Although it is well known that respiratory complications are associated in patients with Down syndrome (DS), airway anomalies are relatively uncommon. We herein report a case of an 11-month-old infant with DS in whom recurrent respiratory symptoms were present after birth and tracheal bronchus was detected by chest CT. The present case was a boy who was born weighing 2,344 g at 36 weeks of gestational age, whose APGAR score (5 minutes) was 9 points without newborn asphyxia. Congenital facial anomalies were recognized and 21-trisomy was confirmed by G-staining method. Due to increased respiratory rate (60–70/min) and decreased SpO₂ (65%) at age 11 days, chest CT was performed and showed diffuse ground-glass opacities in both lungs. Pulmonary edema or neonatal pneumonia was suspected. Pneumonia was improved by antibiotic therapy. However, wheezing was sustained. Chest CT was performed at 11 months after birth and revealed consolidation in the right upper lobe and mild, diffuse ground-glass opacities in both lungs. In addition, it showed that the right upper bronchus originated directly from the supracarinal trachea. Therefore, the diagnosis of tracheal bronchus (displaced type) was made. Pulmonary edema from DS was considered for diffuse ground-glass opacities in both lungs.