Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was a 7 year old male with a 6 day history of high fever and a nonproductive cough.
Clinical Physical Exam:
Clinical Differential Diagnosis:
A PA chest film from the 6th hospital day showed right upper lobe consolidation and a right pleural effusion. An ultrasound guided paracentesis on the 6th hospital day (not provided) returned an exudate consistent with a parapneumonic effusion. The patient did not respond to antibiotics appropriate to Step pneumoniae. A chest ultrasound from the 13th hospital day (not provided) showed multiple septations in the pleural effusion. A chest tube was placed surgically on the 13th hospital day. An enhanced chest CT exam from the 15th hospital day revealed a large right pleural fluid collection that had an enhancing rim with associated consolidation and atelectasis of the lung.
Imaging Differential Diagnosis:
The patient had 3 other chest tubes placed over the next 2 weeks in order to drain the thick pleural fluid.
Follow-up and Prognosis:
The patient eventually resolved the empyema.
Case 5, Case 25
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
This site complies with the HONcode standard for trustworthy health information: