Treatment of round pneumonia should be followed up with a 2-view chest X-ray weeks later.
Round pneumonia can be treated with antibiotics and should include a follow-up 2-view chest X-ray (CXR) after several weeks to ensure opacity resolution, according to the results of a study published in Radiology Case Reports.
In the case study, investigators monitored a 10-year-old patients with Streptococcus pneumoniae.
The patient was brought to the emergency department with a 5-day intermittent fever of 102º Fahrenheit and a dry cough, as well as malaise and a decreased appetite. Investigators said that the individual had received all recommended vaccinations, provided by the National Vaccine Program.
She had a 98 beats per minute heartrate, her blood pressure was 102/58 mmHg, and her respiratory rate was 34 breaths per minute.
The patient had intact tympanic membranes; a mild injected throat; bilateral small, soft submandibular lymph nodes; and decreased air entry with bronchial breathing. A CXR revealed demarcated homogeneous lesions on the right lobes, which is a sign of round pneumonia.
Laboratory tests revealed normal peripheral blood count, serum electrolyte, serum sugar, serum lactate dehydrogenase, serum uric acid, and renal and liver functions.
A rapid urinary antigen test showed the individual was positive for Streptococcus pneumoniae and blood cultures and a tuberculin test were negative. The patient was treated with intravenous penicillin and gentamicin for 3 days, was discharged, and treated with oral amoxicillin for another 7 days, which is similar to that of lobar pneumonia.
The patient had a follow-up CXR that showed resolving round opacities after 6 weeks. Round pneumonia is mainly present in young patient up to 8 years of age and could be due to underdeveloped collateral airways and inter-alveolar communications, according to the study. This could allow for the dissemination of fluid or bacteria in the lungs.
AlOmran, HI. Unilateral double round pneumonia in a child: a case report and literature review. Radiol Case Rep.2021;16(11):3266-3269. doi:10.1016/j.radcr.2021.07.066