A 10-month-old male infant was admitted with the complaints of fever & cough for 22 days, respiratory distress for 3 days. He was dyspneic, tachypneic (RR-65/min) with SpO2- 95% with oxygen 2L/min by face mask, HR- 10/min with right sided restricted chest movement and diminished breath sound. Initially he was diagnosed as right sided pneumothorax. Chest x-ray was suggestive of congenital lobar emphysema / pneumothorax with pneumonia (Rt). CT of chest revealed emphysematous changes with multiloculated area in right hemithorax with dense opacited base of lung. Per operative finding showed pleural thickening and lacerated middle lobe of right lung due to abscess. And finally infant was diagnosed as ruptured lung abscess of middle lobe with thickened pleura and empyema thoracic. The patient was managed with lobectomy of middle lobe, inj. linezolid after getting C/S which changed to oral form and recovered.