DOI: https://doi.org/10.36347/sasjm.2026.v12i04.018

Pages: 338-340

Congenital lobar emphysema (CLE) is a rare malformation of the bronchopulmonary tree characterized by progressive hyperinflation of one or more pulmonary lobes due to airway obstruction. Bilateral involvement is exceptional and typically presents with severe respiratory distress in early infancy. We report the case of a 45-day-old infant presenting with respiratory distress. Clinical symptoms began in the first days of life with tachypnea, cyanosis, and feeding difficulties. The patient was initially treated as having viral bronchiolitis. Due to the lack of clinical improvement, a chest radiograph was performed, revealing a right apical opacity associated with marked hyperlucency and hyperexpansion of the left lung, widening of the intercostal spaces, flattening of the left hemidiaphragm, and anterior mediastinal herniation. Chest computed tomography (CT) demonstrated consolidation of the apical segment of the right upper lobe, bilateral ground-glass opacities involving the lower lobes and the lingula, and marked hyperlucency of the left upper and middle lobes with vascular attenuation. These findings were highly suggestive of bilateral giant congenital lobar emphysema with superinfection. Surgical lobectomy was performed, and histopathological examination confirmed the diagnosis.