M. Paetzel (Cleveland/USA)  

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5 Years  

Male  

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

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

<- 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).


<- 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.


<- 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.


<- 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)

Imaging including endoscopy  

Pneumonia  

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

N/A  

N/A  

N/A  

Thorax-Lung  

inflammatory or infectious