Respiratory distress is a common presentation in pediatric emergency and pneumonia with empyema is one of the important causes requiring immediate drainage. Accurate and fast diagnosis is the key to successful management. The diagnosis is usually made by chest X ray. X rays take time to diagnose, involve radiation exposure to children and most importantly may miss the diagnosis. We present a case of pneumonia with empyema that was diagnosed using emergency point of care thoracic ultrasound. Following this intercostals chest drainage tube was put and pus was drained. Chest X ray later on showed corroborate findings. This case suggests that point of care ultrasound is feasible and useful investigation for diagnosing empyema in children in emergency and can be used to take a decision for intercostal drainage.

Keywords: Thoracic Ultrasound; Point of Care Ultrasound; Empyema; Emergency.