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Pediatrics
Diagnosis
Chest
Chest Infections
Round Pneumonia
Round Pneumonia
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Bacterial lung infection with very round, well-defined appearance on chest radiography; simulates mass lesion
              • Majority seen in patients < 8 years of age
              • Typically occurs with Streptococcus pneumoniae infection

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. de Benedictis FM et al: Complicated pneumonia in children. Lancet. 396(10253):786-98, 2020
                                      2. Andronikou S et al: Computed tomography in children with community-acquired pneumonia. Pediatr Radiol. 47(11):1431-40, 2017
                                      3. Andronikou S et al: Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents. Pediatr Radiol. 47(11):1405-11, 2017
                                      4. Liszewski MC et al: Lung magnetic resonance imaging for pneumonia in children. Pediatr Radiol. 47(11):1420-30, 2017
                                      5. Schooler GR et al: Children with cough and fever: up-to-date imaging evaluation and management. Radiol Clin North Am. 55(4):645-55, 2017
                                      6. Stadler JAM et al: Lung ultrasound for the diagnosis of community-acquired pneumonia in children. Pediatr Radiol. 47(11):1412-9, 2017
                                      7. Winant AJ et al: Current updates on pediatric pulmonary infections. Semin Roentgenol. 52(1):35-42, 2017
                                      8. Jain S et al: Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 372(9):835-45, 2015
                                      9. Pereda MA et al: Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics. 135(4):714-22, 2015
                                      10. Liu J et al: Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest. 146(2):383-8, 2014
                                      11. Liu YL et al: Pediatric round pneumonia. Pediatr Neonatol. 55(6):491-4, 2014
                                      12. Caiulo VA et al: Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children. Pediatr Pulmonol. 48(3):280-7, 2013
                                      13. Gorkem SB et al: Evaluation of pediatric thoracic disorders: comparison of unenhanced fast-imaging-sequence 1.5-T MRI and contrast-enhanced MDCT. AJR Am J Roentgenol. 200(6):1352-7, 2013
                                      14. Yikilmaz A et al: Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs. Acta Radiol. 52(8):914-9, 2011
                                      15. Restrepo R et al: Imaging of round pneumonia and mimics in children. Pediatr Radiol. 40(12):1931-40, 2010
                                      16. Kim YW et al: Round pneumonia: imaging findings in a large series of children. Pediatr Radiol. 37(12):1235-40, 2007
                                      17. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                                      18. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                      19. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                                      20. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                      21. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                                      22. Price J: Round pneumonia and focal organizing pneumonia are different entities. AJR Am J Roentgenol. 172(2):549-50, 1999
                                      23. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                      24. Wagner AL et al: Radiologic manifestations of round pneumonia in adults. AJR Am J Roentgenol. 170(3):723-6, 1998
                                      25. Katsumura Y et al: Pneumococcal spherical pneumonia multiply distributed in one lung. Eur Respir J. 10(10):2423-4, 1997
                                      26. Wahlgren H et al: Radiographic patterns and viral studies in childhood pneumonia at various ages. Pediatr Radiol. 25(8):627-30, 1995
                                      27. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Bacterial lung infection with very round, well-defined appearance on chest radiography; simulates mass lesion
                                                  • Majority seen in patients < 8 years of age
                                                  • Typically occurs with Streptococcus pneumoniae infection

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. de Benedictis FM et al: Complicated pneumonia in children. Lancet. 396(10253):786-98, 2020
                                                                          2. Andronikou S et al: Computed tomography in children with community-acquired pneumonia. Pediatr Radiol. 47(11):1431-40, 2017
                                                                          3. Andronikou S et al: Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents. Pediatr Radiol. 47(11):1405-11, 2017
                                                                          4. Liszewski MC et al: Lung magnetic resonance imaging for pneumonia in children. Pediatr Radiol. 47(11):1420-30, 2017
                                                                          5. Schooler GR et al: Children with cough and fever: up-to-date imaging evaluation and management. Radiol Clin North Am. 55(4):645-55, 2017
                                                                          6. Stadler JAM et al: Lung ultrasound for the diagnosis of community-acquired pneumonia in children. Pediatr Radiol. 47(11):1412-9, 2017
                                                                          7. Winant AJ et al: Current updates on pediatric pulmonary infections. Semin Roentgenol. 52(1):35-42, 2017
                                                                          8. Jain S et al: Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 372(9):835-45, 2015
                                                                          9. Pereda MA et al: Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics. 135(4):714-22, 2015
                                                                          10. Liu J et al: Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest. 146(2):383-8, 2014
                                                                          11. Liu YL et al: Pediatric round pneumonia. Pediatr Neonatol. 55(6):491-4, 2014
                                                                          12. Caiulo VA et al: Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children. Pediatr Pulmonol. 48(3):280-7, 2013
                                                                          13. Gorkem SB et al: Evaluation of pediatric thoracic disorders: comparison of unenhanced fast-imaging-sequence 1.5-T MRI and contrast-enhanced MDCT. AJR Am J Roentgenol. 200(6):1352-7, 2013
                                                                          14. Yikilmaz A et al: Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs. Acta Radiol. 52(8):914-9, 2011
                                                                          15. Restrepo R et al: Imaging of round pneumonia and mimics in children. Pediatr Radiol. 40(12):1931-40, 2010
                                                                          16. Kim YW et al: Round pneumonia: imaging findings in a large series of children. Pediatr Radiol. 37(12):1235-40, 2007
                                                                          17. Copley SJ: Application of computed tomography in childhood respiratory infections. Br Med Bull. 61:263-79, 2002
                                                                          18. Donnelly LF: Practical issues concerning imaging of pulmonary infection in children. J Thorac Imaging. 16(4):238-50, 2001
                                                                          19. Markowitz RI et al: The spectrum of pulmonary infection in the immunocompromised child. Semin Roentgenol. 35(2):171-80, 2000
                                                                          20. Donnelly LF: Maximizing the usefulness of imaging in children with community-acquired pneumonia. AJR Am J Roentgenol. 172(2):505-12, 1999
                                                                          21. Katz DS et al: Radiology of pneumonia. Clin Chest Med. 20(3):549-62, 1999
                                                                          22. Price J: Round pneumonia and focal organizing pneumonia are different entities. AJR Am J Roentgenol. 172(2):549-50, 1999
                                                                          23. Donnelly LF et al: The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol. 170(6):1627-31, 1998
                                                                          24. Wagner AL et al: Radiologic manifestations of round pneumonia in adults. AJR Am J Roentgenol. 170(3):723-6, 1998
                                                                          25. Katsumura Y et al: Pneumococcal spherical pneumonia multiply distributed in one lung. Eur Respir J. 10(10):2423-4, 1997
                                                                          26. Wahlgren H et al: Radiographic patterns and viral studies in childhood pneumonia at various ages. Pediatr Radiol. 25(8):627-30, 1995
                                                                          27. Kirkpatrick JA: Pneumonia in children as it differs from adult pneumonia. Semin Roentgenol. 15(1):96-103, 1980