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    Case of the Day
    Lung abscess due to staphylococci

    Modality: X-Ray Modality: Ultrasound Modality: CT Modality: MRI

    View here all images of this case in different sizes !



    Go to the top of the page ID: 20020414161820
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     Lung abscess due to staphylococci   
     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ Ultrasound ] There are X-Ray images available for this case. [ CT ] There are X-Ray images available for this case. [ MRI ]   
     Author/s:

    M. Paetzel (Cleveland/USA)  

     
     Email Address:

    Viewable for logged on visitors (Log on)  

     
     Age:

    5 Years  

     
     Gender:

    Male  

     
     History:

    5 year-old boy. Fever for 5 days (up to 39,5°C), cough, oral antiobiotics. No change in findings.  

     
     Pathomorphology or Pathophysiology of this disease :

    In immunocompromised children, pulmonary abscesses are most commonly caused by staphylococci. The abscessing staphylococcus pneumonia has, however, become rare.  

     
     Radiological findings:


    X-ray 1 <- view X-ray 1

    X-ray 1: Left-sided findings on admission: Round opacity in the right lower lobe (red arrow). Right-side: After treatment (ultrasound-guided drainage and 14 days antibiotics): Only minimal pleural thickening (green arrow).


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Located near the thoracic wall, an intrapulmonary process of about 2.5 x 2 x 2 cm can be seen (pointed angle between pleura and process) with membranous wall. After treatment, there is only a hypoechoic leftover of the previous abscess membrane to be seen, which was seen even after many weeks.


    CT 1 <- view CT 1

    CT 1: round, process with isodense fluid with a small air-fluid level. The air which is seen is fairly pathognomonic for an abscess.


    MRI 1 <- view MRI 1

    MRI 1: After treatment: Triangular changes which show increased signals in the area of the right pleura. (This is a residual finding of the abscess' membrane)

     

     
     Diagnosis confirmation:

    Imaging including endoscopy  

     
     Which DD would be also possible with the radiological findings:

    Pneumonia  

     
     Course / Prognosis / Frequency / Other :

    An ultrasonic steered drainage is possible only in lung abscesses close to the walls. In completely intrapulomary abscesses, a CT-steered drainage is possible.  

     
     Comments of the author about the case:

    N/A  

     
     First description / History:

    N/A  

     
     Literature:

    N/A  

     
     Region-Organ:

    Thorax-Lung  

     
     Most likely etiology:

    inflammatory or infectious  

     
     Available images: There are X-Ray images available for this case. [ X-Ray ] There are X-Ray images available for this case. [ Ultrasound ] There are X-Ray images available for this case. [ CT ] There are X-Ray images available for this case. [ MRI ]   
    More cases from these authors: Search M. Paetzel in Medline M. Paetzel (10)     




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