PMC9281412_01
CT scan showed diffuse ground glass opacities and septal thickening consistent with his known history of PAP.
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Ten days into his admission, his oxygen requirements were unchanged and chest CT scan showed diffuse ground glass opacities and septal thickening consistent with his known history of PAP (Fig. 1).
The 3-liter canisters (total of 18L) that used for WLL. The one on the far right is the product of the first wash, which gradually becomes clear as lavage continues. The one on the far left is the product of the last wash.
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Sixteen days into his admission, we performed a WLL on the patients left lung with 18L normal saline (NS) (Fig. 2).
Chest x-rays before hospitalization, throughout this patient's hospital stay and after discharge shows the changes; a- April 6, 2020 x-ray for his PAP follow up which showed improved diffuse airspace opacities, b- December 6, 2020 showed multifocal airspace disease, c- December 15, 2020, no significant change compared to the 12/11/2020 chest radiograph was seen. Multifocal opacities may be due to a combination of pulmonary alveolar proteinosis and multifocal pneumonia in this reportedly Covid positive patient, d- December 19, 2020 mildly worsened findings, specifically in the right lower lobe. Bilateral multifocal opacities are likely both pulmonary alveolar proteinosis and Covid-19 pneumonia, e. December 23, 2020 after lavage shows minimally improved bilateral opacities, f-January 19, 2021 Mildly improved diffuse, bilateral reticulonodular opacities, g- March 2, 2021, Slightly improved diffuse bilateral reticulonodular opacities, April 27, 2021 showed interval improvement of diffuse bilateral reticulonodular opacities.
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