Pediatric Streptococcus Pneumonia

• Etiology: Streptococcus pneumoniae bacteria
• Imaging CXR AP: Look for silhouette sign to locate pulmonary opacity to correct lobe: lingular bacterial pneumonia usually obscures left heart border, right middle lobe bacterial pneumonia usually obscures right heart border, lower lobe bacterial pneumonia usually obscures hemidiaphragm
• Imaging CXR Lateral: Look for spine sign of lower lobe bacterial pneumonia: normally lung should get more lucent going from lung apex to lung base, if lung gets more dense going from lung apex to lung base you have lower lobe bacterial pneumonia
• Imaging US: Heterogenous hypoechoic echotexture similar to liver = hepatization of lung
• DDX: White-out of lung
  — Wth complete atelectasis of lung heart and mediastinum are shifted ipsilaterally
  — With pneumonia and large pleural effusion heart and mediastinum are shifted contralaterally
• Complications:
• Treatment: Antibiotics
• Clinical: Bacterial pneumonia in lower lobes can present with abdominal pain due to irritation of the diaphragm and mimic acute appendicitis so look at lungs on AXR and CT

Radiology Cases of Streptococcus Pneumonia