case_images: PMC4357128_01
case_images: A 5-year-old patient with severe expanding pneumococcal pneumonia. (a) Note "white hemithorax" on the left with increased volume causing mediastinal shift to the right. (b) After a single course of left IV methylprednisolone. Significant improvement in the aeration of the left lung with residual consolidation above the diaphragm. (c) A clinical and radiologic deterioration. (d) Improved aeration of the left lung after a second course of IV steroids.
case_images: CRIPE2015-186302.001.jpg
case_images: PMC4357128_01_CRIPE2015-186302.001.jpg
case_images: fig1
case_images: An additional chest X-ray showed severe expanding consolidation with a mediastinal shift to the right (Figure 1(a)). A repeated chest X-ray 18 hours after steroid administration showed regression of the lung infiltrate with a normal positioned trachea (Figure 1(b)). On the chest X-ray performed 32 hours after steroid treatment a recurrence of the mediastinal shift was detected (Figure 1(c)). A second dose of methylprednisolone was administered to which the patient responded again with the same remarkable response (Figure 1(d)).