Complete hemithorax white out - pediatric empyema

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Breathing difficulties. Increasing oxygen needs.

Patient Data

Age: 3 years
Gender: Male

Complete white out of the left hemithorax with mediastinal shift.

Air bronchogram at the left perihilar region. Right lung clear.

The child underwent a respiratory arrest shortly after this image was acquired.

Endotracheal tube. Left pleural drain.

A large volume of the left sided effusion has resolved. Extensive left sided consolidation, as illustrated by the perihilar air bronchograms.

The mediastinal shift has resolved.

Right perihilar consolidation.

Case Discussion

An emergency pleural drain was inserted with the drainage of frank pus in keeping with an empyema.

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