Congenital pulmonary airway malformation: A case report in a 1-month-old infant

Congenital pulmonary airway malformation (CPAM) is a rare congenital lung anomaly characterized by abnormal bronchial development and localized glandular overgrowth. Although obstetric ultrasound is useful for prenatal diagnosis, many cases are still identified postnatally through imaging such as chest X-ray, computed tomography scan, or magnetic resonance imaging. We report a 1-month-old male infant who presented with respiratory distress from the first week of life and was initially treated for presumed pneumonia without clinical improvement. On admission to our tertiary unit, the differential diagnoses included severe pneumonia, left-sided congenital diaphragmatic hernia, and congenital heart disease. Chest X-ray revealed a large left-sided cystic lung lesion with mediastinal shift to the right, which was confirmed by chest computed tomography scan. The infant underwent left lower lobectomy, with significant clinical improvement and complete resolution of respiratory distress by day 13 postoperatively. This case highlights the diagnostic challenges of CPAM in resource-limited settings, especially when prenatal diagnosis is missed despite repeated antenatal ultrasound scans. Postnatal imaging is essential for confirming the diagnosis, assessing lesion extent, and guiding surgical intervention. However, improved prenatal detection remains critical for early diagnosis, timely referral, and appropriate management.