Toddler with respiratory distress

CXR of respiratory syncytial virus pneumonia and superinfection with community acquired bacterial pneumonia
CXR PA (left) shows central airway thickening and mild lung hyperinflation with a dense opacity in the right upper lobe and a dense opacity in the left lower lobe which is obscuring the left hemidiaphragm (silhouette sign). The lateral radiograph (right) shows dense opacities over the upper spine and over the lower spine (spine sign).

The diagnosis was respiratory syncytial virus pneumonia and superinfection with community acquired bacterial pneumonia.