Severe bacterial pleuropneumonia

Ultrasound examination of the left side of the thorax revealed a moderate amount of anechoic fluid (o) in the pleural cavity (Image A). There are also large areas of consolidated lung (>). In image A, the presence of the fluid allows us to visualize the phrenico-pericardial ligament (arrow) as a filiform hyperechogenic structure floating in it. In image B, the diaphragm (*), liver (+), and spleen (<) can also be identified.

At the right side of the thorax, the ultrasound images show areas of consolidated lung (>) and a moderate amount of pleural fluid (o) in which the presence of fibrin (arrow) is particularly evident, organizing into a dense network and multiple concamerations.
Further examinations: an endoscopic examination of the airways revealed the presence of pharyngeal lymphoid hyperplasia and a significant presence of mucopurulent exudate in the tracheal lumen. The culture test performed on the tracheal aspirate fluid revealed the presence of enrofloxacin sensitive Streptococcus spp.