Multiple choice

A newborn female child, weight 3.5kg, delivered by uncomplicated delivery has developed respiratory distress immediately after birth. On chest x-ray, ground glass appearance was seen. Baby was put on mechanical ventilation and was given surfactant. But the condition of baby deteriorated and increasing hypoxemia was present. A full term female 'sibling' died within a week, with the same complaints. ECHO was normal. Usual cultures were negative. What is your diagnosis?

  1. Total anomalous pulmonary vein connection

  2. Meconium aspiration syndrome

  3. Neonatal pulmonary alveolar proteinosis

  4. Disseminated HSV infection

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C Correct answer
Explanation

Neonatal pulmonary alveolar proteinosis (PAP) presents with respiratory distress and ground-glass appearance unresponsive to surfactant. The family history of a sibling dying with identical symptoms strongly suggests a genetic disorder, and congenital PAP fits this presentation. ECHO rules out cardiac causes, cultures rule out infection.

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