Medical image of the month: air bronchogram sign

• Main Authors: Brucks E, Young R
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2019-10-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: air bronchogram; chest x-ray; adult respiratory distress syndrome; acute myelogenous leukemia; ECMO extracorporeal membrane oxygenation; doxorubicin; cytarabine; treatment; veno-venous; hypoxemia
• Online Access: http://www.swjpcc.com/imaging/2019/10/2/medical-image-of-the-month-air-bronchogram-sign.html

No abstract available. Article truncated after 150 words. An 18-year-old man without any known past medical history presented with a one-day history of progressive shortness of breath. He reported a sudden onset of symptoms the morning of presentation, and an accompanying sensation of confusion with difficulty concentrating. Initial laboratory evaluation was significant for leukocytosis over 60 K/mm3. Due to his increased work of breathing and worsening lethargy, the patient was intubated and sedated for airway protection and ventilatory support. The patient was admitted to the ICU, and his initial chest radiograph was concerning for acute respiratory distress syndrome. Subsequent hematologic analyses from his admission CBC were consistent with a new diagnosis of acute myelogenous leukemia. Despite aggressive alveolar recruitment maneuvers and maximum ventilator support, the patient’s oxygen saturation remained poor and his respiratory reserve continued to decline. The decision was made to place the patient on veno-venous extracorporeal membrane oxygenation (ECMO) prior to initiating therapy with doxorubicin and …