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Normal chest radiograph that was taken after a bicycle accident approximately three months before the onset of the disease.
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A 48 years old female without a history of chronic diseases or drug abuse and with a recently documented normal chest radiograph (Fig. 1) was admitted to the hospital due to acute shortness of breath, respiratory failure and suspected pneumonia.
Chest radiograph and CT three days after the admission (ten days after initiation of symptoms), showing symmetrical bilateral ground-glass opacities and alveolar consolidations in the dependent areas of the lung.
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On the fourth day after admission, CT showed extensive bilateral ground glass opacities and alveolar consolidations (Fig. 2).
Chest radiograph six weeks after presentation. Persistent infiltrates bilaterally are seen, showing limited improvement after high-dose corticosteroid therapy.
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There was a partial improvement, but opacities remained (Fig. 3), and oxygen therapy was required.
Chest radiograph ten weeks after presentation, showing improvement after eight weeks of corticosteroids + mycophenolate mofetil.
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After that, her clinical and radiological picture started to improve gradually (Fig. 4).
Chest radiograph and CT after 1 year of follow-up, showing near-complete regression of infiltrations and minor residual fibrotic changes bilaterally.
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A follow-up 12 months after the beginning of the disease showed significant regression of infiltrates on chest radiograph and CT (Fig. 5).