Mild Subcostal Retractions in Pediatrics — Case | Pediatric Respiratory | SMLE Q#680

SMLE Question #680

Pediatrics Pediatric Respiratory
Last updated: February 2026
A male newborn is delivered vaginally at 38 weeks’ gestation after an uncomplicated pregnancy and labor. He cries immediately and has good tone. At 1 hour of life, he develops tachypnea and intermittent expiratory grunting with mild subcostal retractions. He remains well perfused with no cyanosis. Lung auscultation is clear, and there is no heart murmur. Chest radiograph shows prominent perihilar vascular markings and fluid in the interlobar fissures with normal lung volumes. What is the most likely diagnosis?

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