PMC5971339_01
Chest radiograph on the day of admission noted indistinct increased markings and a patchy opacity in the right lower lung.
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Chest radiography featured indistinct increased markings and a patchy opacity in the right lower lung (Figure 1).
Chest computed tomography angiography (CTA) on the day of admission noting patchy infiltrate in the right middle and lower lung lobes and small bilateral pleural effusions.
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Chest computed tomography angiography (CTA) found no evidence of pulmonary embolism but did reveal a patchy infiltrate in the right middle and lower lobes with small bilateral pleural effusions and enlarged hilar lymph nodes (Figure 2).
Repeat chest computed tomography angiography (CTA) on hospital day 5 featuring progressive ground-glass opacities bilaterally, which, in the setting of continued hemoptysis, was concerning for diffuse alveolar hemorrhage.
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A repeat chest CTA noted progressive ground-glass opacities bilaterally (Figure 3), which, in the setting of continued hemoptysis, increased concern for diffuse alveolar hemorrhage (DAH).
Brain magnetic resonance imaging (MRI) demonstrated symmetrical bilateral hyperintensities on T2-weighted imaging and fluid-attenuated inversion recovery (FLAIR) sequences consistent with cerebrocortical edema.
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Urgent brain MRI demonstrated symmetrical bilateral hyperintensities on T2-weighted imaging and fluid-attenuated inversion recovery (FLAIR) sequences consistent with cerebrocortical edema (Figure 4); there was no evidence of acute infarct or hemorrhage.