School ager with cough and fever

CXR of adenovirus pneumonia with bacterial superinfection
Initial CXR PA (left) shows central airway thickening and bilateral lung hyperinflation resulting in flattening of the diaphragm. CXR PA obtained 3 days later (right) shows new dense opacities obscuring the left and right heart borders (silhouette sign).

The diagnosis was initially adenovirus pneumonia which was later complicated by bacterial superinfection.