Presentation
Productive cough for several weeks. Febrile, back pain, vomiting, and lethargy on presentation.
Patient Data
Rounded ill-defined region of dense consolidation centered in right upper lobe posterior segment. Favored to be infective/inflammatory in origin. Traversing internal air bronchograms. Perifocal small rounded ground glass/nodular consolidation limited by adjacent oblique fissure, no extension into superior segment right lower lobe. Mildly enlarged right hilar node likely reactive.
Subsequent chest x-ray demonstrating rounded mass in right upper lobe with rounded consolidation as the differential. The rest of the lungs are clear.
Case Discussion
Rounded mass was seen on CT thoracic spine scout initially as the patient presented with back pain and infective symptoms. CT chest was instead performed to rule out an abscess. Further history elicited a background of cough with brown sputum.
Sputum culture demonstrated pneumococcal infection. The patient was treated with antibiotics and upon clinical improvement discharged into the community for follow-up with GP.
Round pneumonia most commonly occurs in patients under the age of 12 with cases in adults being a rarity 1.
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