A 27-year-old patient reporting a history of a 2-meters fall with a chest impact 1 week before, was admitted to intensive care unit for acute respiratory failure. He complained of persistent pain radiating to the right shoulder, without fever or any other symptoms. Because of rapidly worsening dyspnea, he was intubated on the day of admission. Chest computed tomography scan showed condensation of the entire right lung with an air bronchogram of the right bronchial tree consistent with gas in the bronchi surrounded by abnormally dense fluid-filled pulmonary alveoli, with a moderate right pleural effusion (Fig. 1). There was also non-obstructive fluid with the main right bronchus. The left lung was uninjured and there was no radiological evidence for post-traumatic injury. Bacteremic pneumococcal pneumonia was diagnosed.

Fig. 1
figure 1

Chest computed tomography (coronal minimum-intensity projection [MinIP] image) showing condensation of the entire right lung, while the left lung is uninjured

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Even if it occurs in a relatively unsuspicious context, pneumococcal pneumonia is usually responsible for a single or multilobar pneumonia with a sudden onset of severe infectious signs including high fever and chills, along with chest pain, cough, purulent expectoration, and sometimes dyspnea.