A 15 month old presented with pyrexia, raised inflammatory markers and a cough.
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There is a 3.5 cm rounded opacity in the right lower zone, which does not silhouette the right hemidiaphragm. This is most likely ‘round pneumonia’ in the posterior segment of the right lower lobe.
A repeat chest x-ray was performed post antibiotic treatment showing full resolution.
Round pneumonia can simulate a mass. It is always located within the posterior, usually lower lobes.It is typically secondary to bacterial infection with Streptococcus pneumoniae, Staph aureus or Haemophilus influenzae. Typically it is a spherical area of consolidation which may or may not contain air bronchograms. Often it is slightly irregular in outline. It can rapidly change shape and/or size. Like any pneumonia follow up chest x-ray post treatment should show complete resolution.