A 47 yo male presented with malaise, cough, and a low-grade fever over several weeks. He was found to have serum oxygen saturation of 88% on room air. Laboratory evaluation was notable for leukopenia to 2.5. Frontal chest radiograph & CT images is attached. Help please.

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X ray wise b/l haziness,no pleural effusion.presents like atypical/viral pneumonia.CT shows ground glass appearance with cysts.was serology done for the patient sir?with the above information differential diagnosis include: 1.chronic interstitial diseases or acute alveolar diseases. 2.Opportunistic infections like : pneumocystis pneumonia (PCP) cytomegalovirus pneumonia (CMV) herpes simplex virus pneumonia (HSV) respiratory syncytial virus bronchiolitis (RSV) 3.aspergillosis but then this patient has to be severely immunocompromised since I think halo sign is present in CT. 4.ARDS 5.SLE.

Dear Shigil. ..ARDS in this pt less likely because of several weeks complaints. .. Thank you so much for nice approach
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DDS... 1. PCP PNEUMONIA. .HIV. 2..ILD..IDIOPATHIC PULMONARY FIBROSIS 3..TB. .ATYPICAL PRESENTATION. . Thanks dear@Dr. Naveen. R

Dr suresh sir What is Ards..to some extent I know What's its patho..to.some.extent I know I know that we have treat precipitating cause of ards But I do not know what is the treatment of Ards itself How to treat pul infiltrates of pul oedema which is hall mark of ards Plz guide ur student I will be whole heartdly thank full to u
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If we see alone xray This is perfect pic for bat wing appearance But As per history the dgx comes to viral pneumonia both sides But again such b/l viral pneumonia can give rise to ards

Thank you sir
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Bilateral GGO with peripheral sparing with internal cysts in between Atypical infections most likely Go for sputum examination and TT accordingly Any immunosuppressive stat?? Otherwise DDs given by dr.shigil very well I agreed

Thank you sir
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Bilateral reticular shadows with cyst formation- typical of lymphocytic interstitial pneumonitis Dd 1. HIV 2 sjogrens syndrome PCP pneumonia, lam are also dd

@Dr. Suresh Narayanan @Dr. Shigil Mathew Sir your opinions
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Bilateral ground glass opacities with reticulation and few cysts possibly pneumocystis jiroveci pneumonia

Thanks mam
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ground-glass opacity with interlobular septal thickening with scattered thin-walled, round cysts throughout both lungs.

Thanks mam
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Its a case of pneumonia.

Thanks sir
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d/d: Diffuse alveolar hemorrhage Pulmonary alveolar proteinosis

Thanks sir
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Peripheral spearing is there atypical pnumonia viral or fungal .. any history of heaomptysis??

Thanks sir
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