CTICasesStaphylococcus aureus Necrotizing Pneumonia with Macklin Phenomenon
Imaging findings
High-resolution chest CT shows multifocal areas of necrotizing consolidation in the lungs containing small cavities, or Cheerios, representing localized areas of necrosis. There is also extensive pulmonary interstitial emphysema presenting as linear bands of air tracking along bronchovascular bundles, mediastinal emphysema, and visceral pleural thickening, indicative of the Macklin phenomenon.
Key takeaways
Necrotizing pneumonia, commonly caused by Staphylococcus aureus, is characterized by tissue necrosis and cavitation (often described as Cheerios when presenting as small round cavities surrounded by ground-glass opacity). Severe alveolar rupture can lead to air dissection along the bronchovascular sheath to the hilum and mediastinum, known as the Macklin phenomenon, manifesting as interstitial and mediastinal emphysema.
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