Case Id: JSSMCRADC0067

Figure 1: Chest X-Ray AP view on day 1

 

Figure 2 Chest X-Ray AP view after 3days
Figure 3 Axial CT thorax -Lung window

 

Figure 1: Chest X-Ray AP view on day 1 shows consolidation in the left mid zone
Figure 2 Chest X-Ray AP view after 3days shows pnematoceles and mediastinal shift
Figure 3 Axial CT thorax -Lung window shows extensive pneumatoceles with mediastinal shift
FINAL DIAGNOSIS STAPHYLOCCOCAL PNEUMONIA WITH PNEUMATOCELES

 

Staphyloccal pneumonia

  • Most common bronchopneumonia
  • Overwhelming majority hospital-acquired
  • Most common cause of death during influenza epidemics
  • Rarely develops in healthy adults
  • Hemolyzes blood agar
    • Coagulase positive
  • Its ability to produce pathology in humans is due to its production of coagulase
  • Produces its pathologic reaction in the conducting airways

Imaging

  • Rapid spread through the lungs
  • Empyema, especially in children
  • No air bronchogram
  • Pneumothorax
    • Pyopneumothorax
  • Abscess formation
  • Bronchopleural fistula

In children

  • Rapidly developing lobar/multilobar consolidation
  • Pleural effusion (90%)
  • Pneumatocoele

    In adults

  • Patchy bronchopneumonia of segmental distribution, frequency bilateral
  • May be associated with atelectasis since airways are filled (not so with pneumococcal)
  • Pleural effusion (50%)