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Round pneumonia

Case contributed by Andrew Dixon
Diagnosis probable

Presentation

Fever and cough

Patient Data

Age: 6 years
Gender: Female
x-ray

There is a roughly 4cm diameter density in right lower zone medially with preservation of the right heart border and hemidiaphragm outlines indicating that this is most likely located posteriorly. There is no rib splaying or erosion.

In the absence of clinical history, the differential for this posterior lesion in a child might include round pneumonia, bochdalek hernia, diaphragmatic eventration, pulmonary sequestration, pulmonary or pleural mass / abscess and possibly a posterior mediastinal neurogenic or neuroblastic tumor.

Case Discussion

In this case the clincal history was 3 days of cough and right upper quadrant pain suggesting round pneumonia as the cause.

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