Pediatric Round Pneumonia

Abstract

"Round pneumonia" or "spherical pneumonia" is a well-characterized clinical entity that seems to be less addressed by pediatricians in Taiwan. We herein report the case of a 7-year-old boy who presented with prolonged fever, cough, and chest X-rays showing a well-demarcated round mass measuring 5.9 × 5.6 × 4.3 cm in the left lower lung field, findings which were typical for round pneumonia. The urinary pneumococcal antigen test was positive, and serum anti-Mycoplasma pneumoniae antibody titer measurement using a microparticle agglutination method was 1:160 (+). After oral administration of antibiotics including azithromycin and amoxicillin/clavulanate, which was subsequently replaced by ceftibuten due to moderate diarrhea, the fever subsided 2 days later and the round patch had completely resolved on the 18th day after the diagnosis. Recent evidence suggests treating classical round pneumonia with antibiotics first and waiving unwarranted advanced imaging studies, while alternative etiologies such as abscesses, tuberculosis, nonbacterial infections, congenital malformations, or neoplasms should still be considered in patients with atypical features or poor treatment response.

Outbreak of mycoplasmal round pneumonia in an adult population: A case series

“…M. pneumoniae was responsible for the round pneumonia outbreak in the present case series. We are aware of only one previous case of round pneumonia because of this pathogen . In that case, a solitary opacity was detected on chest radiography of a child.…”

“…Round or spherical pneumonia has been described in children and adults, and is identified by spherical or oval lesions distributed non‐segmentally on pulmonary imaging. The characteristic appearance of round pneumonia is thought to result from inflammation and exudation as infection spreads among alveolae via the pores of Kohn and canals of Lambert.…”

“…It occurs in children and less often in adults . To our knowledge, round nodules have been reported only once as the primary radiographic manifestation of mycoplasmal pneumonia, when paediatric patients presented with obvious symptoms . In other words, mycoplasmal pneumonia, which frequently causes community‐acquired pneumonia, rarely manifests as round nodules.…”

“…Pneumonia, which can be classified as spherical or round based on imaging, may be caused by several pathogens, including viruses and bacteria, as well as atypical pathogens, fungi and parasites . It occurs in children and less often in adults . To our knowledge, round nodules have been reported only once as the primary radiographic manifestation of mycoplasmal pneumonia, when paediatric patients presented with obvious symptoms .…”

“…Pneumonia, which can be classified as spherical or round based on imaging, may be caused by several pathogens, including viruses and bacteria, as well as atypical pathogens, fungi and parasites . It occurs in children and less often in adults .…”