Demographics:
18 months old, Female
Indication:
Pneumonia
Findings
Chest radiograph
- Extensive airspace opacification throughout the right lung
- Mild patchy left basilar opacification
- At least moderate-sized right and small left pleural effusions
CT
Chest
- Large, complex, multiloculated right hydropneumothorax with associated visceral and parietal pleural thickening and enhancement
- The right lung is largely collapsed with multiple areas of parenchymal hypoattenuation with intermixed gas, some of which extend to the visceral pleural surface
- Several collections border the mediastinal pleural surface without discrete mediastinal collections or pneumomediastinum
- Small, simple appearing left pleural effusion with overlying atelectasis and additional patchy groundglass opacification throughout the left lung
- Mild leftward mediastinal shift
- Small pericardial effusion
Upper abdomen
- Trace perihepatic ascites
MSK
- No acute findings
Diagnosis
Empyema Lung abscesses
Sample Report
Findings concerning for necrotizing pneumonia involving much of the right lung complicated by pulmonary abscesses, pneumatoceles, and a large multiloculated right empyema.
Mild leftward mediastinal shift.
No evidence of mediastinal abscess.
Small, simple appearing left pleural effusion.
Groundglass opacities throughout the left lung could represent areas of atelectasis or additional sites of infection.
Trace perihepatic ascites.
Discussion