case_images: PMC8669828_01
case_images: Lung ultrasonography (LUS) of the right chest. LUS examination on anterior, subaxillary, and posterior chest away from the spine. (A) B-mode ultrasound, we can see that the pleural line and A-line clearly existed but no B-line was found. (B) M-mode ultrasound; it presented as a stratosphere sign. It was confirmed as the severe PTX according to the International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis.
case_images: fped-09-779615-g0001.jpg
case_images: PMC8669828_01_fped-09-779615-g0001.jpg
case_images: F1
case_images: The stratosphere sign was presented under M-mode ultrasound (Figures 1A,B), while the lung sliding disappeared under real-time ultrasound, which was confirmed as severe PTX in the right chest.
case_images: Lung ultrasonography (LUS) of the posterior chest. LUS examination of the right back close to the spine (A) and the left back (B) presents large consolidation with air bronchograms. Lung pulse is found under real-time ultrasound, which confirms the presence of large area atelectasis in bilateral lungs.
case_images: fped-09-779615-g0002.jpg
case_images: PMC8669828_01_fped-09-779615-g0002.jpg
case_images: F2
case_images: LUS revealed large-area lung consolidations with air bronchograms (Figure 2A), which was confirmed as atelectasis. LUS of the left lung revealed severe pulmonary atelectasis (Figure 2B).
case_images: Lung ultrasonography (LUS) examination after thoracocentesis. LUS examination shows resolution of atelectasis in bilateral lungs after pleural puncture therapy. The right upper-lung and lower-lung field mainly present as confluent B-line (but the A-line can be found in the middle-lung field), which suggests some degree of lung edema (A). The left lung in the last intercostal space reveals snowflake signs while the remaining intercostal spaces present as ground-glass opacities, which are characteristic of respiratory distress syndrome (RDS) (B).
case_images: fped-09-779615-g0003.jpg
case_images: PMC8669828_01_fped-09-779615-g0003.jpg
case_images: F3
case_images: After a total of 520 ml of gas was removed, the right PTX disappeared thoroughly, as did bilateral atelectasis, and the LUS manifested as B-lines in his right lung, while it presented as ground glass opacity sign and snowflake signs in his left lung, which was confirmed as mild-moderate respiratory distress syndrome (RDS) (Figure 3).
case_images: PMC8669828_02