Multiple Pulmonary Nodes and Thoracic Pain: A Case Report

Date of submission: 13-07-2020 | Date of acceptance: 25-01-2021 | Published: 02-07-2021


  • Sofia Vasconcelos Pediatrics Department, Senhora da Oliveira Hospital, Guimarães, Guimarães, Portugal
  • Ana Maia Ferreira Pediatrics Department, Portuguese Institute of Oncology of Porto Francisco Gentil, Porto, Portugal



There is limited data about the prevalence of pulmonary nodules in healthy children and no guidelines for their diagnosis and management. We report a case of a nine-year-old boy with thoracalgia aggravated by inspiration. Chest radiography showed pneumonia and, after treatment with azythromicin, there was imagiologic aggravation. Chest computer tomography showed multiple nodular lesions compatible with metastasis syndrome. He had normal blood panel (including inflammatory and neoplastic markers) and positron emission tomography with hypermetabolism of 18F-FDG on multiple pulmonary nodules. He was submitted to a pulmonary biopsy with positive culture for Staphylococcus warneri. To our knowledge this is the first report of pneumonia due to this agent. This pattern of mild manifestations suggests a low virulence. Immunocompetent patients rarely need lung biopsy to diagnose pneumonia, however, in difficult cases, it can help determine the diagnosis leading to adequate treatment.


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