Presentation
Five day history of subjective fevers and sweats. Dull right chest discomfort. Shortness of breath and cough. Recent travel.
Patient Data
Dense consolidation in the anterior and posterior segments of the right upper lobe. Patchy increased lung markings in the middle part of the right lung.
No filling defects within the pulmonary arterial tree to the subsegmental branches to indicate acute pulmonary embolism.
Dense consolidation with air bronchograms throughout the anterior and posterior segments of the right upper lobe, extending into the apical segment of the right upper lobe. Local smooth peri-bronchial thickening consistent with airway inflammation. No features of abscess formation.
Additional sites of patchy peri-bronchial dense and ground glass consolidation in bilateral lower lobes and the right upper lobe. Mild peri-bronchial thickening in bilateral lower lobes.
No pleural effusion or empyema.
Interval reduction in size/extent of wedge-shaped lobar consolidation in the right upper lobe laterally. Resolution of inflammatory changes elsewhere in the lungs.
No new consolidation or pleural effusion.
Case Discussion
This case of community-acquired pneumonia demonstrates both lobar pneumonia (dense consolidation with air bronchograms) and bronchopneumonia patterns (patchy peri-bronchial consolidation).
A causative organisms was not isolated in this case, however mycoplasma or another atypical infection was favored. The patient responded to five days of broad spectrum antibiotics and was discharged home.
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