PMC7573660_01
Initial bilateral pulmonary opacities.
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He was further noted to be in septic shock likely secondary to pneumonia as chest X-ray (CXR) showed bilateral pulmonary opacities (Figure 1).
Worsening bilateral diffuse opacities.
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Repeat CXR upon worsening symptoms showed increased bilateral diffuse opacities concerning for acute respiratory distress syndrome (ARDS) (Figure 2).
Supraventricular tachycardia with ventricular rate > 190 bpm.
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He again worsened to developed unstable supraventricular tachycardia (SVT) requiring electrical cardioversion for return to sinus rhythm (Figure 3).
Diffuse bilateral airspace opacities with dense opacification in the left midlung.
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FiO2 80-90%) despite treatment and therapeutic anticoagulation; hence, he was started on convalescent plasma and high-dose steroids on day 27 of admission (Figure 4). Following a long course of critical illness, he was able to be weaned off of vasopressors and ventilatory support.
Bilateral lower lobe traction bronchiectasis, evidence of emphysema, post ARDS fibrosis with interlobar septal thickening from recent viral infection, diffuse subpleural cysts, multiple thick-walled cavitary lesions concerning for bacterial superinfection with intrapulmonary abscesses in the lower lobes.
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He was also noted to have multiple thick-walled cavitary lesions in the right middle lobe, bilateral bases, and left basilar cavitary abscess 5.4 x 3.5 cm (Figures 5 and 6).
Filling defects in the right lower lobe, right middle lobe, and left upper lobe subsegmental arteries.
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He was also noted to have multiple thick-walled cavitary lesions in the right middle lobe, bilateral bases, and left basilar cavitary abscess 5.4 x 3.5 cm (Figures 5 and 6).