Presentation
Admitted to ICU with necrotizing fasciitis, septic shock and acute renal failure. Progressive respiratory failure requiring ventilation.
Patient Data
Age: 65 years
Gender: Male
From the case:
Acute respiratory distress syndrome (ARDS)
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Multifocal bilateral air-space opacities, in a predominantly perihilar and lower zone distribution.
Case Discussion
This is a characteristic appearance of ARDS in the appropriate clinical context.
The differential diagnosis includes infection (also a common complication of ARDS), and cardiogenic pulmonary edema. Differentiation can be impossible in some cases.
The causes of ARDS include:
- trauma
- septicemia
- hypovolemic shock
- fat embolism
- near-drowning
- burns
- viral pneumonia
- pancreatitis
- oxygen toxicity
- disseminated intravascular coagulopathy
ARDS mortality is high, around 50%, and many survivors develop chronic lung disease, with damaged lung healing by fibrosis. A minority recover fully.
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