Pneumatocele formation in adult pneumonia

Pneumatocele formation is unusual in adult pneumonia, particularly in pneumococcal pneumonia. We report three cases of pneumatocele formation in adults, including one with probable pneumococcal pneumonia. All three patients were severely ill and two expired. Although they are usually asymptomatic, pneumatoceles may enlarge and compress the adjacent lung and mediastinum. This occurred in two patients causing respiratory insufficiency and cardiovascular compromise. The placement of a chest tube into the enlarging pneumatocele resulted in successful decompression.