Time for another #RadiologyRounds 🫁
A woman in her 30s with no past medical history presents with acute dyspnea, fever and a non-productive cough.
She has no sick contacts or recent travel. She is not on home medications and smokes cigarettes and occasionally vapes.
A woman in her 30s with no past medical history presents with acute dyspnea, fever and a non-productive cough.
She has no sick contacts or recent travel. She is not on home medications and smokes cigarettes and occasionally vapes.
What is the predominant imaging abnormality?
She is found to have diffuse bilateral patchy ground-glass opacities with some interlobular septal thickening.
She has escalating oxygen requirements and was initially started on broad-spectrum empiric antimicrobial therapies
She has escalating oxygen requirements and was initially started on broad-spectrum empiric antimicrobial therapies
Her initial serum infectious work-up and RVP are negative. She denies any new occupational or home exposures. She does not appear to respond to antibiotics after 72 hours.
What is your leading differential at this time?
What is your leading differential at this time?
You proceed with a bronchoscopy with BAL to obtain a cell count and diff and culture data.
Which cell type would confirm your leading diagnosis?
You start empiric steroids (prednisone 60 mg daily) given concern for acute eosinophilic pneumonia. Within 48 hours she is weaned off HFNC and was discharged home on D7 on room air with close pulmonary follow-up.
She was amenable to tobacco cessation therapies and was followed closely outpatient with tapering of her steroids over 4 weeks.
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