DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.002

Pages: 2189-2192

Pulmonary abscess in children is a relatively rare disease that results from a pulmonary infection causing significant destruction of the lung parenchyma, leading to the development of a well-defined cavity with thick walls containing purulent material due to suppuration and tissue necrosis [1,2]. Imaging is the cornerstone of pulmonary abscess diagnosis. We report the case of a 6-year-old child, with no prior medical history, who was admitted to the emergency department due to progressive dyspnea for 15 days following a thoracic trauma from a fall onto a stone. The examination revealed dyspnea with signs of pleural effusion. The laboratory tests revealed an inflammatory syndrome, characterized by leukocytosis of 27970/mm³ and a CRP level of 197mg/L. Hydatid serology and HIV serology were both negative. The radiograph shows a dense, homogeneous opacity in the left lung field, which is confirmed on the CT scan as a large cystic formation with hypodense liquid content, enhancing peripherally after contrast injection. This is responsible for collapse of the ipsilateral lung parenchyma, with deviation of the mediastinal structures towards the contralateral side. On ultrasound, the lesion appears with finely echogenic content, with thick, incomplete septa, and is non-vascularized on color Doppler. Intravenous antibiotic therapy was initiated, resulting in clinical and biological improvement in the child, as confirmed by a reduction in abscess size on follow-up imaging. This case highlights the importance of prompt management and rigorous follow-up, with the use of advanced imaging, particularly CT scan, to confirm the diagnosis and guide treatment.