Fig. 1

A 2-year-old child presenting with 4 days of fever, cough, and intermittent grunting respirations. Pleural fluid tested positive for pneumococcal antigen. a Initial plain chest radiograph showing right mid-zone airspace opacity, consistent with pneumonia. b Plain chest radiograph 24 h later revealing a large right-sided pleural effusion. c Lung ultrasonographic image taken immediately afterwards depicting the pleural effusion and heterogeneous parenchymal echo texture, consistent with an underlying necrotizing pneumonia. d Plain chest radiograph 4 days later following thoracoscopy and removal of chest drains demonstrates right upper zone cavities within the region identified previously by ultrasonography