Case 29

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

Clinical History:
The patient was a 2 year old female who presented to an outside hospital with respiratory distress. She was diagnosed with pneumococcal pneumonia. She worsened and was admitted to the outside intensive care unit on the 11th hospital day. Her clinical course was complicated by bilateral airleak and a cavitary lung lesion. She was transferred to our institution on the 21st hospital day, on mechanical ventilation. The patient was tried on high frequency ventilation for 1 day, and then placed on ECMO the next day.

Clinical Physical Exam:
Severe respiratory distress.

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Pneumonia

Imaging Findings:
AP chest film from the 32nd hospital day demonstrated diffuse airspace disease and the cavity in the right lower lobe. A chest CT exam obtained the next day defined the nature of this right lower lobe lesion further.

Image 1

Images 2 and 3

Imaging Differential Diagnosis:
Pneumatocele

Operative Findings:
None

Pathological Findings:
None

Final Diagnosis:
Pneumatocele, Post Bacterial Infection

Follow-up and Prognosis:
Not available.

Similar Cases:
Case 22

References:

• Paediapedia

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