This is a case of rounded pneumonia with cavitary lung abscess in a pediatric patient.

CT guided lung biopsy revealed Streptococcus anginosus, an oral anaerobe which commonly causes lung abscess and empyema and can cross fissures, and Eubacterium brachy, which is a cause of periodontitis and a rare cause of lung abscess. Lung infections are commonly multi-microbial. The superior segments of the lower lobes are common sites for aspiration in the recumbent position. No history of dysphagia in this case, however silent aspiration can occur in children.

One of four sputum cultures grew Mycobacterium chelonae which is ubiquitous in the environment and rarely causes lung disease. This is an unlikely pathogen in this case.

The patient was given a 3-week course of amoxicillin and clavulanic acid.

Co-authors:
Travis Bevington, MD
Camille Dumas, DO