Presentation
Cough and fever.
Patient Data
Well-defined rounded opacity in the right upper zone is most compatible with round pneumonia given the history.
No other focal opacity noted. No effusion or pneumothorax.
Cardiothymic silhouette is normal in size.
No hilar or mediastinal lymphadenopathy.
Case Discussion
Given the patient’s age and presentation, the imaging findings should be interpreted as “round pneumonia”. A solitary metastatic nodule is uncommon at this age.
Round pneumonia is almost exclusively visualized during thoracic imaging of pediatric patients. The shape of these infiltrates may be explained by anatomical characteristics that predispose pediatric patients to develop more compact, less diffuse infiltrates.
As with all bacterial pneumonia, the causative pathogen in round pneumonia is most often S. pneumoniae. Round pneumonia is treated with appropriate antibiotic therapy as for community-acquired pneumonia.
This case was submitted with supervision and input from:
Soni C Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center
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