PMC7765722_01
AP-supine chest radiograph: visible consolidation in the left inferior lobe of the lungs. The right lung had no apparent abnormality.
CRIPE2020-8875119.001.jpg
PMC7765722_01_CRIPE2020-8875119.001.jpg
fig1
Anteroposterior (AP) view of chest X-ray (CXR) obtained in the radiology department showed left inferior lobar pneumonia (Figure 1). Compared to the previous chest X-ray (Figure 1), no lucency was seen, possibly pneumonia with air cavitation.
CXR AP and lateral view demonstrating focal area of consolidation in the left inferior lobe dominant. On the AP view, there are multiple small lucency in the left lung field suspicious for possible congenital pulmonary airway malformation (CPAM) and possible pneumonia with air cavitation. Compared to the previous CXR (Figure 1), no lucency was observed.
CRIPE2020-8875119.002.jpg
PMC7765722_01_CRIPE2020-8875119.002.jpg
fig2
A second CXR (Figure 2) was obtained in the radiology department.
CXR AP and lateral view showing an air-filled cavitary lesion in the infero-posterior left lobe.
CRIPE2020-8875119.003.jpg
PMC7765722_01_CRIPE2020-8875119.003.jpg
fig3
During the hospitalization, the condition became worse, and on day 8, she was followed by a follow-up by CXR (Figure 3) combined with lung ultrasonography (LUS) (Figures 4 and 5), showed multiple large air-filled cavitary lesions in the left lung.
LUS left anterior using M-mode showing no pneumothorax and posterior lower and middle using B-mode: pleural effusion (transudate), pleural irregular thickening, and heterogeneous parenchymal echo texture.
CRIPE2020-8875119.004.jpg
PMC7765722_01_CRIPE2020-8875119.004.jpg
fig4
During the hospitalization, the condition became worse, and on day 8, she was followed by a follow-up by CXR (Figure 3) combined with lung ultrasonography (LUS) (Figures 4 and 5), showed multiple large air-filled cavitary lesions in the left lung.
Noncontrast axial-chest CT: mediastinal window (a) and lung window (b). Left pleural effusion density was <25 HU. There was a poorly visible portion of the left lung, and there was air-filled thin wall cavity. Without IV contrast, cavitary necrosis could not be diagnosed because there was no enhancement of the surroundings.
CRIPE2020-8875119.005.jpg
PMC7765722_01_CRIPE2020-8875119.005.jpg
fig5
During the hospitalization, the condition became worse, and on day 8, she was followed by a follow-up by CXR (Figure 3) combined with lung ultrasonography (LUS) (Figures 4 and 5), showed multiple large air-filled cavitary lesions in the left lung. CT scan was done without contrast, as the parent refused for contrast administration (Figures 5-7). CT scan images revealed consolidation with multiple cavities or pneumatoceles consistent with necrotizing pneumonia, left pleural effusion density was <25 Hounsfield units (HU), and collapse of partial left superior lobe.
Noncontrast frontal view chest CT: lung window (a) and virtual bronchography (volume-rendered display) for visualization of airways (b, c).
CRIPE2020-8875119.006.jpg
PMC7765722_01_CRIPE2020-8875119.006.jpg
fig6
CT scan was done without contrast, as the parent refused for contrast administration (Figures 5-7). CT scan images revealed consolidation with multiple cavities or pneumatoceles consistent with necrotizing pneumonia, left pleural effusion density was <25 Hounsfield units (HU), and collapse of partial left superior lobe.
Noncontrast frontal view chest CT, image reformatting volume rendered display: coronal reformation in standard lung window to allow three-dimensional view. Pneumatoceles, thin-walled cavities developing secondary to necrosis.
CRIPE2020-8875119.007.jpg
PMC7765722_01_CRIPE2020-8875119.007.jpg
fig7
CT scan was done without contrast, as the parent refused for contrast administration (Figures 5-7). CT scan images revealed consolidation with multiple cavities or pneumatoceles consistent with necrotizing pneumonia, left pleural effusion density was <25 Hounsfield units (HU), and collapse of partial left superior lobe.
Follow-up chest radiograph obtained 6 months after hospitalization. Frontal CXR has no apparent abnormality.
CRIPE2020-8875119.008.jpg
PMC7765722_01_CRIPE2020-8875119.008.jpg
fig8
Follow-up chest radiograph was obtained 6 months after hospitalization and revealed no abnormalities Figure 8).