Early-onset Sepsis and Pneumonia Observed as Respiratory Distress Syndrome

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Abstract
• Lung maturity was assessed in nine neonates with early-onset sepsis and/or pneumonia first observed as respiratory distress syndrome (RDS). All but one infant had at least one clinical or laboratory feature in the immediate postnatal period that suggested infection. Five patients had a mature phospholipid pattern in tracheal or gastric secretions, suggesting that RDS was not present; four patients had an immature pattern, suggesting that RDS coexisted with early-onset sepsis and/or pneumonia. Neither clinical nor radiologic features differentiated patients whose surfactant phospholipid patterns were mature from those whose patterns were immature. The presence of a mature surfactant complex in an infant with RDS should suggest the presence of infection. The presence of an immature pattern, however, does not exclude the presence of infection since RDS may coexist with early-onset sepsis and/or pneumonia. (Am J Dis Child 134:766-768, 1980)