PMC8349039_01
Anterior-posterior (AP) portable chest radiograph on admission showing mixed interstitial and alveolar infiltrates in the bilateral lower lungs. There are no localized consolidation or confluence noted.
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Inflammatory Response Syndrome (SIRS) criteria for sepsis with tachycardia, fever of 100.7  F, and a white blood cell count of 12,700 cells/mm. Initial chest x-ray on admission showed mild patchy alveolar opacities bilaterally in the basilar lung fields concerning for atypical pneumonitis, which also provided a source for the sepsis diagnosis (Fig. 1).
CT Chest High Resolution, coronal (2a) and axial (2b) view on hospital day 2. Interval worsening of bibasilar and peripherally predominant consolidations with associated interstitial thickening and bronchiectasis. Subpleural sparing and multiple subpleural nodules are seen within the upper lobes.
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Repeat high resolution CT chest showed interval worsening of the patient's ground glass opacities in addition to moderate bibasilar pleural effusions concerning for a superimposed infectious process (Fig. 2).
AP chest radiograph on hospital day 3. Illustrates interval worsening of patchy lower lobe predominant opacities, now involving the mid-lungs bilaterally and right upper lung. Indistinctness of the pulmonary vasculature.
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Repeat chest radiograph showed interval worsening of her bilateral basilar predominant patchy opacities with involvement of the right middle and upper lobes (Fig. 3).
a and 4b: Coronal and axial CT chest images one month after hospital discharge.
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She received a high-resolution CT chest one month following hospital discharge, which showed complete resolution of previous lung findings without evidence of resultant fibrotic changes (Fig. 4).