The Role of Thoracic Ultrasound in a Rare Combination of Lung Abscess and Congenital Pulmonary Airway Malformation (CPAM): Case Report and Literature Review

Abstract Background Congenital Pulmonary Airway Malformation (CPAM) is a rare congenital lung abnormality characterized by cystic lesions. Diagnosis is often made prenatally via ultrasound or postnatally through thoracic imaging. Case presentation: A two-year-old girl presented with fever, rhinitis, asthenia, and hypoalimentation. Initial antibiotic therapy did not resolve her symptoms. Laboratory tests showed elevated CRP, neutrophilic leukocytosis, anemia, and thrombocytosis. Suspecting Kawasaki disease, intravenous immunoglobulins and acetylsalicylic acid were administered, but fever recurred. Thoracic ultrasound revealed a 5.5 cm anechoic formation with hyperechoic spots, indicative of a lung abscess within CPAM. Chest radiography confirmed a posterior basal opacity with coarse air-fluid levels. The patient was transferred to a regional center for further management, where the diagnosis was confirmed, and surgical intervention was planned. Conclusions Thoracic ultrasound plays a crucial role in the diagnosis and management of CPAM, particularly when complicated by infections such as lung abscesses. Early and accurate diagnosis can significantly improve patient outcomes, as demonstrated in this case report.