71 yom w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), CKD3, BPH, LLE DVT (on apixaban), HTN, dyslipemia, hypothyroidism, and positive HBV surface antigen who presented with
- acute kidney injury.
- Hospital course complicated by
- worsening kidney failure, hypoxemic
- respiratory failure from
- DAH,
- MSSA PNA.
- uremic encephalopathy,
- hyperkalemia,
- E faecalis UTI, and MSSA pneumonia/bacteremia.
- Intubated for severe hypoxemic respiratory failure refractory to maximal HFNC support.
- Bronchoscopic findings were
- consistent with DAH.
- CXR 1 month ago
-
71M CXR 1 month ago Normal CXR
Dx lungs kidneys pulmonary hemorrhage anca vasculitis
Ashley Davidoff TheCommonVein.net1 Month Later Diffuse Alveolar Hemorrhage and MSSA Pneumonia
Multicentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia
CXR shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.netMulticentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia. Note Consolidation surrounded by ground glass opacity, the latter likely reflecting a hemorrhagic component
CTscan shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.netMulticentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia. Note Consolidation surrounded by ground glass opacity, the latter likely reflecting a hemorrhagic component
CTscan shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.netMulticentric Pulmonary Hemorrhage and Pneumonia
71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia. Note Consolidation surrounded by ground glass opacity, the latter likely reflecting a hemorrhagic component
CTscan shows multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia
Ashley Davidoff TheCommonVein.net
CXR 1 week Later Shows Significantly Improved Multicentric Pulmonary Hemorrhage and Pneumonia

71 yo m w/ a hx of recently diagnosed ANCA-associated vasculitis (diagnosed by kidney biopsy), presents with acute respiratory failure. Bronchoscopic findings were consistent with diffuse alveolar hemorrhage associated with MSSA (Methicillin Sensitive Staph Aureus ) pneumonia/bacteremia
CXR 1 week after CT scan shows significant improvement of multicentric consolidations likely a combination of alveolar hemorrhage and pneumonia. It is well known that pulmonary hemorrhage resolves fairly quickly
Ashley Davidoff TheCommonVein.net
reference ID 6195