Soon afterwards, he was admitted to the ICU with respiratory insufficiency and signs of bilateral alveolar infiltrates on chest X-ray.
Chest X-ray on admission showed bilateral alveolar infiltrates. Enterobacter aerogenes and Enterococcus faecalis were isolated from a bronchus aspirate on admission.
(1) He had the Rapid onset of respiratory distress, diffuse crackles on lung examination, bilateral, confluent alveolar infiltrates
on chest roentgenogram and progressive arterial hypoxemia refractory to supplemental oxygen therapy.
A diagnosis of DAH should be entertained only when a patient presents with diffuse alveolar infiltrates
. Diffuse alveolar hemorrhage may occur with or without associated capillaritis; however, it is typically the cases with capillaritis that may present with clinical manifestations of ALI.
Computed tomography (CT) scan of his chest showed multiple pulmonary nodules and alveolar infiltrates
with small cavities suggestive of septic infarctions.
Of note on the chest radiograph were right upper lobe alveolar infiltrates
All hallmarks of the most severe form of acute lung injury, the acute respiratory distress syndrome (ARDS) are present: dyspnoea, refractory hypoxaemia, an inflammatory response, reduced pulmonary compliance and diffuse alveolar infiltrates
on chest radiography (2).
The classic chest radiograph reveals bilateral, diffuse alveolar infiltrates
consistent with alveolar flooding The absence of cardiomegaly and pleural effusion radiographically distinguishes ARDS from cardiogenic pulmonary edema.
A chest radiograph showed bilateral alveolar infiltrates
. A pulmonary arteriograph showed no evidence of pulmonary emboli.
A case was defined as occurring in a patient with bilateral alveolar infiltrates
that required intubation and mechanical ventilation.
One week later, a chest radiograph showed bilateral alveolar infiltrates
suggestive of pulmonary edema (Figure).
Radiographic changes exhibited at admission consisted of bilateral interstitial infiltrates in 14 patients (56%), alveolar infiltrates
in 4 (16%), and mixed infiltrates in 5 (20%) patients.