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1845 Pediatrics

A 3.5 kg male infant born at term after an uncomplicated pregnancy and delivery develops respiratory distress sholy after bih and requires mechanical ventilation. The chest radiograph reveals a normal cardiothymic silhouette but a diffuse ground glass appearance to the lung fields. Surfactant replacement fails to improve gas exchange. Over the first week life, the hypoxemia worsens. Results of routing culture and echocardiographic findings are negative. A term female sibling died at 1 month of age with respiratory distress. Which of the following is the most likely diagnosis?

ANeonatal pulmonary alveolar proteinosis
BMeconium aspiration
CTotal anomalous pulmonary venous return
DDisseminated herpes simplex infection
Pediatrics
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