CTICasesNecrotizing Pneumonia with Pleural Empyema
Imaging findings
CT chest with contrast enhancement shows extensive left lower lobe consolidation with multiple focal areas of non-enhancement (necrosis) and small cavity formation, associated with a large, loculated, pleural effusion demonstrating pleural enhancement and thickening (split pleura sign).
Key takeaways
Contrast-enhanced CT is essential when evaluating complicated pneumonias and pleural effusions. It allows for clear differentiation between simple consolidative pneumonia and necrotizing pneumonia/abscess formation, which requires more aggressive drainage. The 'split pleura' sign is highly specific for empyema.
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