Correct!
5. All of the above

The opacities on the chest radiograph engender a large number of differential diagnostic considerations. In the absence of prior imaging studies, such bilateral opacities are frequently assumed to represent acute pulmonary disease. The differential considerations for acute, multifocal areas of pulmonary ground-glass opacity and consolidation are numerous, and include increased pressure edema (hydrostatic edema), diffuse pulmonary infection (including opportunistic infections in the setting of an immunocompromised patient), diffuse pulmonary hemorrhage, non-infectious causes of pulmonary injury (such as a hypersensitivity reaction resulting from an environmental exposure or medication), and other non-infectious inflammatory insults of lung, such as developing acute respiratory distress syndrome/diffuse alveolar damage, or acute eosinophilic pneumonia. Any of the above choices could present with the findings on the chest radiograph.

The patient was treated with broad spectrum antibiotics and diuresis. Four months later, a repeat chest radiograph was performed (Figure 2).

Figure 2. Repeat chest radiograph 4 months after the initial chest radiograph.

Which of the following statements regarding the chest radiograph is most accurate?

  1. The chest radiograph appears essentially unchanged from the previous radiograph
  2. The chest radiograph shows cavitation developing within the areas of multifocal ground-glass opacity and consolidation
  3. The chest radiograph shows new multiple nodules, suggesting superimposed infection
  4. The chest radiograph shows progressive multifocal bilateral ground-glass opacity and consolidation
  5. The chest radiograph shows significant improvement in multifocal bilateral ground-glass opacity and consolidation

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