PMC8348909_01
Serial chest radiography: diffuse bilateral ground glass opacities on the day of admission (a); improvement of opacities after first dose of steroid (b); worsening opacities after four days without steroid (c); and improvement of opacities on the second day after restarting steroid (d).
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The chest radiography showed non-homogeneous air space opacities (Fig. 1-a) and the initial blood gas analysis showed an arterial partial pressure of oxygen (PaO2) of 66.2 mmHg while the patient was receiving 6 L/min of oxygen via nasal cannula (P/F ratio: 146). The chest radiograph showed an improvement in diffuse ground-glass opacity (Fig. 1-b). The chest X-ray on day 5 of MICU stay showed worsening of the opacities (Fig. 1-c). His FiO2 requirement decreased to 30% and the opacities on the chest radiograph resolved significantly (Fig. 1-d).
Sequential sampling of bronchoalveolar lavage (BAL) fluid showing progressive hemorrhagic return.
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The BAL fluid aliquots were progressively bloodier, suggesting DAH (Fig. 2).