Commonly misdiagnosed round pneumonia in a child: a case report

  • Khai Quang Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • Nghia Quang Bui Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • Tho Kieu Anh Pham Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • Tri Duc Nguyen Can Tho Children’s Hospital, Can Tho City, Vietnam
  • Quan Minh Pham Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • NhuThi Huynh Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • Ly Cong Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0000-0003-0090-7289
  • Nam Hoang Do Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
  • Phuong Minh Nguyen Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
Keywords: pneumonia, Streptococcus, vancomycin

Abstract

Round pneumonia, a specific radiological finding in children, is often caused by Streptococcus pneumoniae; but it is easily misdiagnosed with some other diseases, causing many difficulties for clinicians. We described a case report of round pneumonia in a 9-year-old boy, with chest pain, following fever, productive cough, left-sided pulmonary consolidation syndrome, tachypnea, no chest indrawing, and a round homogenous lesion about 4 cm in diameter with a clear border in the left upper lobe position on chest X-ray. He was initially misdiagnosed as a lung tumor. He was correctly diagnosed with round pneumonia prior to pneumonectomy and was successfully treated with antibiotics. Therefore, it is important to carefully analyze round pneumonia cases that are often misdiagnosed, resulting in poor therapy.

References

Restrepo R, Palani R, Matapathi UM, Wu YY. Imaging of round pneumonia and mimics in children. Pediatr Radiol. 2010;40(12):1931-40. https://doi.org/10.1007/s00247-010-1767-7

Ceyhan M, Ozsurekci Y, Aykac K, Hacibedel B, Ozbilgili E. Economic burden of pneumococcal infections in children under 5 years of age. Hum Vaccin Immunother. 2018;14(1):106-10. Erratum in: Hum Vaccin Immunother. 2021;17(7):2350. https://doi.org/10.1080/21645515.2017.1371378

Gupta S, Goyal P, Rosinski A. A disappearing lung mass: round pneumonia. Am J Med. 2019;132(8):e656-7. https://doi.org/10.1016/j.amjmed.2019.03.030

Kim YW, Donnelly LF. Round pneumonia: imaging findings in a large series of children. Pediatr Radiol. 2007;37(12):1235-40. https://doi.org/10.1007/s00247-007-0654-3

Ma J, Zhang C, Dang K, Liao Y, Feng X, Zhou P. Spherical pneumonia caused by Ralstonia mannitolilytica: a case report and literature review. BMC Pulm Med. 2023;23(1):20. https://doi.org/10.1186/s12890-023-02316-8

AlOmran HI. Unilateral double round pneumonia in a child: a case report and literature review. Radiol Case Rep. 2021;16(11):3266-9. https://doi.org/10.1016/j.radcr.2021.07.066

Liu YL, Wu PS, Tsai LP, Tsai WH. Pediatric round pneumonia. Pediatr Neonatol. 2014;55(6):491-4. https://doi.org/10.1016/j.pedneo.2013.01.014

Antón E. A frequent error in etiology of round pneumonia. Chest. 2004;125(4):1592-3. https://doi.org/10.1378/chest.125.4.1592

Cunha BA, Gran A, Simon J. Round pneumonia in a 50-year-old man. Respir Care. 2013;58(7):e80-2. https://doi.org/10.4187/respcare.02219

Camargo JJ, Camargo SM, Machuca TN, Perin FA. Round pneumonia: a rare condition mimicking bronchogenic carcinoma. Case report and review of the literature. Sao Paulo Med J. 2008;126(4):236-8. https://doi.org/10.1590/S1516-31802008000400010

MacMahon H, Austin JH, Gamsu G, Herold CJ, Jett JR, Naidich DP, et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology. 2005;237(2):395-400. https://doi.org/10.1148/radiol.2372041887

Claessens YE, Berthier F, Baqué-Juston M, Perrin C, Faraggi M, Keita-Perse O, et al. Early chest CT-scan in emergency patients affected by community-acquired pneumonia is associated with improved diagnosis consistency. Eur J Emerg Med. 2022;29(6):417-20. https://doi.org/10.1097/MEJ.0000000000000955

Upchurch CP, Grijalva CG, Wunderink RG, Williams DJ, Waterer GW, Anderson EJ, et al. Community-acquired pneumonia visualized on ct scans but not chest radiographs: pathogens, severity, and clinical outcomes. Chest. 2018;153(3):601-10. https://doi.org/10.1016/j.chest.2017.07.035

Tran KQ, Pham VH, Nguyen PM, Tran HD, Li HQ, La VG, et al. Lobar pneumonia and bacterial pathogens in Vietnamese children. Curr Pediatr Res. 2020;24(7):247-53.

Published
2023-12-27
How to Cite
1.
Tran KQ, Bui NQ, Pham TKA, Nguyen TD, Pham QM, Tran NH, Tran LC, Do NH, Nguyen PM. Commonly misdiagnosed round pneumonia in a child: a case report. Med J Indones [Internet]. 2023Dec.27 [cited 2024Feb.21];1(1). Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/7117
Section
Case Report/Series