Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 22 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 22

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Chief Complaint:
Two and a half year old female with respiratory distress.

Clinical History:
The patient was a 2 and 1/2 year old female with respiratory distress. A chest film diagnosed pneumonia. Blood cultures grew out pneumococcus. She developed a left sided effusion that became an empyema.

Clinical Physical Exam:
Respiratory distress.

Clinical Labs:
Blood culture positive for pneumococcus

Clinical Differential Diagnosis:
Pneumonia, bacterial

Imaging Findings:
AP chest film from the first hospital day showed a left lower lobe infiltrate. AP chest film from the 8th hospital day suggested a developing cavity in the left lower lobe. Enhanced chest CT exam on the 8th hospital day revealed a cystic lesion forming in the left lower lobe, along with extensive infiltrate and atelectasis and effusion. Repeat enhanced chest CT exam on the 21st hospital day demonstrated enlargement and progression of the left lower lobe lesion and a left sided tension pneumothorax.

icon gifImage 1

icon gifImage 2

icon gificon gifImages 3 and 4

icon gificon gifImages 5 and 6

Imaging Differential Diagnosis:
Pneumatocele / Tension Pneumothorax secondary to rupture of pneumatocele.

Operative Findings:
The patient continued to have a rocky clinical course, remaining febrile on IV antibiotics and then on PO antibiotics after discharge. Two months after the initial presentation the patient was taken to the operating room and the pneumatocele was drained of air and a small amount of fluid.

Pathological Findings:
The fluid, when cultured, grew out Moraxella catarrhalis.

Final Diagnosis:
Pneumatocele, Post Bacterial Infection / Pneumothorax, Tension

Follow-up and Prognosis:
The patient remained afebrile and recovered after given antibiotics to cover Moraxella catarrhalis.

Similar Cases:
Case 29

References:

Title Page


Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

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.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.