A Case Report on Round Pneumonia in a Geriatric Patient

Round pneumonia is a rare clinical entity in adults and may radiographically resemble malignant lung lesions, often leading to diagnostic uncertainty. We present the case of a geriatric patient with a background of diabetes mellitus, hypertension and lichen sclerosis who arrived with a five-day history of fever, generalised body ache, right ear pain, fatigue and decreased appetite. She was febrile with mild tachycardia, and her investigations revealed leukocytosis, significantly raised C-reactive protein and procalcitonin levels, indicating systemic bacterial infection. Chest X-ray demonstrated a well-circumscribed, rounded opacity in the left lung, while CT imaging showed a corresponding wedge-shaped ground-glass consolidation. Differential diagnoses included bronchogenic carcinoma, however, malignancy was considered less likely owing to the absence of weight loss, hemoptysis and the rapid improvement of radiological and inflammatory markers following treatment. She received intravenous broad-spectrum antibiotics, bronchodilators, nebulisation, proton-pump inhibitors and supportive therapy, with antivirals discontinued after bacterial infection was confirmed. Her symptoms resolved progressively, inflammatory markers normalised, and imaging showed regression of the lesion. She was discharged with oral medications and follow-up advice. This case reinforces the importance of considering round pneumonia in adults to prevent misdiagnosis and avoid unnecessary invasive investigations.