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Non-cardiogenic pulmonary edema

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Intracranial hemorrhage with obstructive hydrocephalus.

Patient Data

Age: 4-year-old

Chest Radiograph

x-ray

Bilateral diffuse air-space opacities sparing the apices and basal regions. Pleural spaces appear clear. Cardiomediastinal contours are unremarkable. Endotracheal and nasogastric tubes are in a good position. Temperature monitoring catheter noted. 

Case Discussion

Features are those of nonspecific bilateral airspace opacities, with differentials including pulmonary edema, infection, and pulmonary hemorrhage. The clinical history of increased intracranial pressure in this ICU patient, with no increased septic markers, that guide us for non-cardiogenic pulmonary edema as the likely cause. 

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