H. Frimmel (Halle/S.)  

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11 Years  

Male  

Thorax-Lung  

inflammatory or infectious  

11 year old boy; for 2 weeks, persisting, mainly dry cough. Subfebrile temperatures to moderate fever of 39°C.  

Inflammation of the lung due to infection with mycoplasma. Predominantly inflammatory reaction of the lung interstitium.  

<- view X-Ray 1

X-Ray 1: Thoracic image on the day of introduction. Transparency is decreased in the right middle and lower lobes. In the p.a. image, it is not able to be determined in which lobe it is located (Interstitial findings - ground glass).




<- view X-Ray 2

X-Ray 2: Thoracic image after 14 days of erythromycin treatment: Normal thoracic findings.

 

Total constellation (Consens)  

Pathomorphological display and clinical symptoms of pneumonias are often similar, even when caused by different agents. The radiological display usually does not direct us to the agent.
The different interstitial-alveolar opacities give a hint of which agents may come in question:
- interstitial: Viruses, "atypical" agents (mycoplasma, chlamydia, rickettsia), fungi
- alveolar: Bacteria (pneumococci, legionella, klebsiella).

Even allergic, physical and chemical noxious agents can cause a pneumonia.  

Interstitial pneumonia = reaction of the lung due to various noxious agents, predominantly in interstitium, but also later in the alveolar space.
X-ray: interstitial (reticular) opacity through thickening of the interlobular septae, mostly striped, peri-bronchovascular, perihilar and subpleural opacities. Disseminated, discrete nodules.
= reticular, striped and nodular lung opacities, diffuse milky murkiness (but also alveolar infiltration with discrete to obvious infiltrates with invasion of the alveolar sparce possible). Increased intrathoracic lymph nodes are often seen in viral pneumonias. Pleural effusions and scarring are seldom (differential diagnosis: bacterial superinfection).  

N/A  

N/A  

1. Medline:
Krahe,T.
Bildgebende Diagnostik von Lunge und Pleura
G.-Thieme-Verlag Stuttgart 1998  

Pneumonia, intersititial pneumonia, atypical pneumonia, mycoplasma pneumoniae, Mycoplasma pneumonia, child, childhood, pediatric radiology  

H Frimmel. Mycoplasma pneumonia. PedRad [serial online] vol 2, no. 11.
URL: www.PedRad.info/?search=20021112125011