Thoracic empyema

Case contributed by Hisham Alwakkaa

Presentation

Patient presented to ER with fever and cough.

Patient Data

Age: 8 years
Gender: Female
ultrasound

There is moderate-to-large-sized pleural effusion with multiple septations/loculations associated with underlying consolidation.

x-ray

There is extensive opacification of the left lower lobe with complete silhouetting of the left hemi-diaphragm on frontal and lateral projections. Associated moderate to large-sized pleural effusion is present. Loss of the crescentic appearance of the pleural effusion is present which indicates loculations/empyema.

Case Discussion

This is a case of pneumonia complicated by parapneumonic effusion and empyema. Ultrasound is the primary modality in evaluating parapneumonic effusion in children by identifying the size and presence or absence of debris and septations. It is superior to CT scan in showing septations. In addition, it has an essential role in therapeutic procedures by guiding drainage especially in cases of loculations.

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