Abstract A 78-year-old male with a history of treated prostate carcinoma and heavy smoking presented with acute febrile illness and a right upper zone opacity on chest radiography. Contrast-enhanced CT (CECT) revealed dense consolidation superimposed on pre-existing emphysematous bullae, creating the characteristic “Swiss cheese sign.” Comparison with a PET-CT from six months prior confirmed that these lucencies corresponded to baseline emphysema rather than new cavitary disease. This radiological “pearl,” combined with elevated inflammatory markers, allowed for a confident diagnosis of bacterial pneumonia. The patient was managed with antibiotics, avoiding invasive biopsy, and showed interval radiological resolution.
Abraham et al. (Thu,) studied this question.