What is the most likely diagnosis?
The most likely diagnosis is that of a pneumatocele.
What is the likely underlying pathophysiology of the lesion.
Pneumatocoeles are usually post-pneumonic, often following Staph. aureus infection.
The child is treated with appropriate antibiotic therapy for the underlying Staph. aureus infection. What are the treatment options for the pneumatocele?
Usually, post-pneumonic pneumatoceles resolve after about 6 weeks. So, aside from a repeat film, nothing is required.
In what situations might surgical intervention be required?
If the pneumatocele exerts enough mass-effect to cause cardiovascular or respiratory compromise or if it ruptures resulting in a non-drainable pneumothorax.
Confirmation of the chest radiograph findings. Right upper lobe air-cyst with moderately thick walls - the previously demonstrated air-fluid level is no longer apparent.
The background lung parenchyma appears normal on these selected slices although movement artefact is present.