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Streptococcal Pneumonia in Neonatal Respiratory Distress

Michael L. Wyman, MD; Patrick D. Lester, MD
JAMA. 1980;244(18):2046. doi:10.1001/jama.1980.03310180016013.
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To the Editor.—  We refer to the article by Miller et al (243:1176, 1980) concerning neonatal respiratory distress. We would like to add a note regarding the importance of streptococcal pneumonia.As greater strides have been made in the prevention and treatment of both respiratory distress syndrome (RDS) and meconium aspiration syndrome, we and others have found that streptococcal pneumonia persists and thus is becoming the most notable killer among the various causes of respiratory distress in the newborn.1,2 It is treatable with penicillin early in its course but tragically is not often treated until too late, because the chest roentgenogram is interpreted as uncomplicated RDS.1,3,4 We believe it is crucial that the roentgenographic appearance of neonatal streptococcal pneumonia is often indistinguishable from uncomplicated RDS, (ie, diffuse granular appearance with or without air bronchograms) and that trying to make the distinction can result in a lethal delay in

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