CTICasesNecrotizing Pneumonia with Bulging Fissure Sign
Imaging findings
Chest radiograph and chest CT demonstrate dense, heavy consolidation in the right upper lobe that is associated with posterior displacement and bulging of the major fissure, representing the "bulging fissure sign," along with multiple internal areas of necrosis and cavitation.
Key takeaways
The bulging fissure sign is a classic radiologic sign of heavy lobar consolidation that exerts mass effect on adjacent fissures, typically caused by necrotizing organisms such as Klebsiella pneumoniae, Streptococcus pneumoniae, or Pseudomonas. The sign indicates significant inflammatory exudation and alveolar swelling within the affected lobe.
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