case_images: PMC7573660_01
case_images: Initial bilateral pulmonary opacities.
case_images: CRICC2020-8876932.001.jpg
case_images: PMC7573660_01_CRICC2020-8876932.001.jpg
case_images: fig1
case_images: He was further noted to be in septic shock likely secondary to pneumonia as chest X-ray (CXR) showed bilateral pulmonary opacities (Figure 1).
case_images: Worsening bilateral diffuse opacities.
case_images: CRICC2020-8876932.002.jpg
case_images: PMC7573660_01_CRICC2020-8876932.002.jpg
case_images: fig2
case_images: Repeat CXR upon worsening symptoms showed increased bilateral diffuse opacities concerning for acute respiratory distress syndrome (ARDS) (Figure 2).
case_images: Supraventricular tachycardia with ventricular rate > 190 bpm.
case_images: CRICC2020-8876932.003.jpg
case_images: PMC7573660_01_CRICC2020-8876932.003.jpg
case_images: fig3
case_images: He again worsened to developed unstable supraventricular tachycardia (SVT) requiring electrical cardioversion for return to sinus rhythm (Figure 3).
case_images: Diffuse bilateral airspace opacities with dense opacification in the left midlung.
case_images: CRICC2020-8876932.004.jpg
case_images: PMC7573660_01_CRICC2020-8876932.004.jpg
case_images: fig4
case_images: FiO2 80-90%) despite treatment and therapeutic anticoagulation; hence, he was started on convalescent plasma and high-dose steroids on day 27 of admission (Figure 4). Following a long course of critical illness, he was able to be weaned off of vasopressors and ventilatory support.
case_images: Bilateral lower lobe traction bronchiectasis, evidence of emphysema, post ARDS fibrosis with interlobar septal thickening from recent viral infection, diffuse subpleural cysts, multiple thick-walled cavitary lesions concerning for bacterial superinfection with intrapulmonary abscesses in the lower lobes.
case_images: CRICC2020-8876932.005.jpg
case_images: PMC7573660_01_CRICC2020-8876932.005.jpg
case_images: fig5
case_images: He was also noted to have multiple thick-walled cavitary lesions in the right middle lobe, bilateral bases, and left basilar cavitary abscess 5.4 x 3.5 cm (Figures 5 and 6).
case_images: Filling defects in the right lower lobe, right middle lobe, and left upper lobe subsegmental arteries.
case_images: CRICC2020-8876932.006.jpg
case_images: PMC7573660_01_CRICC2020-8876932.006.jpg
case_images: fig6
case_images: He was also noted to have multiple thick-walled cavitary lesions in the right middle lobe, bilateral bases, and left basilar cavitary abscess 5.4 x 3.5 cm (Figures 5 and 6).