Editorial
Fig. 1.
Chest Radiograph illustrating pneumatoceles
A 28-year-old male, known intravenous drug user, presented with a four-day history of productive cough and fever. Inspiratory crackles were heard throughout both lung fields. Cardiac examination revealed a tricuspid regurgitation murmur. Methicillin-sensitive Staphylococcus aureus was cultured from blood on three separate occasions. Transthoracic echocardiogram confirmed moderate tricuspid regurgitation. Chest radiograph revealed bilateral pneumatoceles, many in evolution with surrounding consolidation.[1] Pneumatoceles are thin-walled, air-filled cysts in the lung parenchyma.[2,3] The likely pathogenesis is necrosis of lung parenchyma, allowing one-way air-flow into the interstitial space.[2,3]. Infection is a common cause, most often Staphylococcus aureus. It has been reported that a high portion of Staphylococcus aureus infections resulted in pneumatocele formation.[1,2]Other causes include trauma and hydrocarbon aspiration.[2] The major complications of pneumatoceles are pneumothoraces and haemoptysis.[2,4] First-line treatment in cases of infective aetiology is antibiotics, and surgical intervention is rarely needed.[2]
References
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