Pleuropneumonia In a 7 Year Old Boy

Background: Pleuropneumonia takes a prominent place in childhood morbidity. Very often in children it can be manifested with atypical clinical presentation.

Objective: To present atypical case of Pleuropneumonia in a seven year old boy.

Methods: Seven year old boy with acute onset headache, abdominal pain, vomiting and febrile. On physical examination conscious, febrile (39 C), pale, dehydrated, pharynx hyperemic, abdominal distension and pain on abdominal palpation. Blood test with leucocytosis (Le= 31), elevated infalamotory markers (CRP=221mg/l), abdominal ultrasound with normal findings. Abdominal x ray - Mesohypogastric righ with distended intestinal viscera and with hydroaeric levels in formation. Due to suspicion of an acute abdomen, the child was transferred to the surgical department. After 12 hours of obsrevation still febrile, dehydrated, but with acute appearance of tachidispnea and chest pain on the left hemitorax. On examination febrile 40 C, tachidispnoic. Lung auscultation - vesicular breathing weakened to the left in the middle and basal parts. Chest x ray - Paracardiac basal left with larger zone of non-homogeneous shading in addition to inflammatory consolidation, right with peribronchitic infiltrates and sings of pleural effussion - Left dome of the diaphragm isn’t followed and left frenicocostal sinus is shaded. Pleural ultrasound showed pleural effusion in left frenicocostal sinus.

Chest X ray

Results: After appropriate antibiotic treatment, oxygen therapy, corticotherapy and inhalation therapy with a complete regression of the auscultatory finding. Control chest x ray and pleural ultrasound with complete regression of inflammatory consolidation and pleural effusion.

Conclusion: Very often pleuropneumonia in children can be manifested with atypical clinical picture and it’s a diagnostic and therapeutic problem because it’s often not recognized and not thought of.