A Condition Mimicking Lung Mass Appearance in Childhood: Round Pneumonia

In childhood, pneumonia is one of the major infectious diseases responsible for significant morbidity and mortality. Clinical and radiographic features of round pneumonia simulate pulmonary masses. Streptococcus pneumoniae, Mycobacterium tuberculosis, and Klebsiella pneumoniae are the most frequent etiologic agents of Round pneumonia in children. A two-year-old boy presented with fever, cough, respiratory distress, tachypnea, suprasternal-intercostal retractions, rales and expiratory wheezes. In the laboratory findings white blood cell count was 17300/mm3, neutrophils 56%, erythrocyte sedimentation rate 54 mm/hour, C-reactive protein 68.84 mg/L, and chest radiogram showed right perihilar 2.5 cm density. In the chest computed tomography scan a 24 mm size irregular contoured consolidation-atelectasis complex in the superior segment of the lower lobe of right lung, demineralization at the right side of T5 vertebra and enlargement at the neural foramina was present. Thorax-abdomen magnetic resonance imaging was performed to exclude neuroblastoma. The spinal cord and neural foramina were normal. The case was discussed at the Aegean University Medicine Faculty Pediatric Respiratory-Allergy Council and the round consolidation with air bronchogram was consistent with round pneumonia. Clinical and radiographic recovery was performed after third generation cephalosporin treatment. In this case we aim to mention the round pneumonia which mimics lung masses.