Post-Pneumonic Poor Air Entry

[ssstrong]

Hello, a 2 years old male presented with typical picture of lobar pneumonia, examination showed localized crepitation with no air entry in the right lower lobe and CXR showed right lower zone infiltration, after 10 days with antibiotic treatment, the fever subsided but there is still poor air entry, what could be the possible cause ?

Thank You

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[Rutgers06]

Hello, a 2 years old male presented with typical picture of lobar pneumonia, examination showed localized crepitation with no air entry in the right lower lobe and CXR showed right lower zone infiltration, after 10 days with antibiotic treatment, the fever subsided but there is still poor air entry, what could be the possible cause ?

Thank You

I would be concerned about a foreign body aspiration...

 

[ssstrong]

I would be concerned about a foreign body aspiration...

Thank you, does any complication of pneumonia give the same picture ?

 

[Cuthbert]

Thank you, does any complication of pneumonia give the same picture ?

Possible residual atelectasis from a pneumonia. I typically follow a child with serial xrays when I suspect this (if the child is otherwise well - no tachypnea, fever, etc). If you have concerns on vitals or exam I would consider further workup for foreign body as Rutgers indicated (as that could also cause atelectasis). A CT scan may be in this child's future but I would repeat the film first - consider inspiratory and expiratory films.