Acute worsening of congenital lobar emphysema with subsequent spontaneous improvement

The degree of respiratory dysfunction and subsequent morbidity of patients with congenital lobar emphysema (CLE) are related to the degree of hyperinflation of the involved lobe. Whereas neonates with severe CLE may have marked respiratory distress requiring surgical resection of the hyperinflated lobe, children with mild forms of CLE seldom have a sudden increase in size of the involved lobe leading to respiratory failure. We report two infants with mild CLE who were clinically stable and developed respiratory distress with increased hyperinflation of the involved lobe associated with an acute respiratory tract infection. Both infants returned to their base line clinical status with conservative therapy alone following resolution of their respiratory illness.