42yr / M, non smoker, non hypertensive, presented with cough, Right chest pain and SOB since 3days following exposure to Rainy weather. He is Coal handler by profession. He suddenly got desaturated after taking lunch. his CXR, ABG enclosed. Possibility and Management please. His SPO2 with Oxygen support became 62%




I think its ARDS or pulmonary edema in view of sudden onset but chances of ARDS are more coz you have not given any cardiac history of this pt....further investigations are needed....Acute Pneumonitis leading to ARDS....

Yes it is. Patient responding to treatment. Thanks.

Is ecg and echo normal? Because in pneumoconiosis there should not be sudden onset of blns and desaturation, x-ray shows rt lz pneumonitits. D/d ? Pneumonia with early ards, ? Septic renal shutdown, ? Dka underlying, or pulmonary embolism, or any cardianc problem. ? Is pt alcoholic? H/o not awailable so pls start venti support, o2 suplliment, broadspecrum sensitive anti biotics is tc high, steroid, bronchodilator and chest physiotherapy. Etc.


Coal workers pneumoconiosis

Its a case of pneumoconiosis...

X ray shows left lower lobe consolidation with right pleural thickening as patient is coal worker so it is anthracosis

Yes it's Pneumonitis. But his sudden Desaturation and ABG needs to be explained and managed.

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ARDS .....Lt lower lobe consolidation with ARDS

Yes! He is being managed in the same line. On ventilation and diuretic with hydrocortisone and Antibiotics. Response initially is good.

Pneumonitis rt lower zone. Broad spectrum antibiotics sputum & blood culture

Coal worker pneumoconiosis

Mechanical ventilation is required using high inspired oxygen, usually for a long time. A positive end-expiratory pressure (PEEP) of 5-15 cm H2O

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