PMC2958626_01
Postero anterior radiograph of the chest obtained after tracheal intubation on day 1.
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Admission chest X-ray showed diffuse bilateral infiltrates (Figure 1).
(a) CT scan of the chest obtained on day 1 showing diffuse alveolar infiltrate. (b) CT scan of the chest obtained on day 8: right ground glas opacities and atelectasis of the left lower lobe.
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A CT scan of the chest on day 1 demonstrated diffuse alveolar infiltrates more pronounced in the lower lobes (Figure 2(a)). Another CT scan of the chest performed on day 8 showed a marked regression of alveolar infiltrates but the presence of ground-glass opacities (Figure 2(b)).
PaO2/FiO2 ratio during invasive ventilation.
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An open-lung biopsy was performed on day 9 due to persistent hypoxemia despite protective ventilation (Figure 3).
Bedside open lung biopsy performed on day 9 (HES x 200): lesions of bronchiolitis obliterans with organizing fibroblastic polyps in alveoli.
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Pathological analysis pointed out typical lesions of bronchiolitis obliterans with organizing fibroblastic polyps in bronchioles, alveolar ducts and alveoli but without inflammatory cells (Figure 4).