The frontal chest x-ray shows
Bilateral ground glass opacity in the shape of a bat’s wing.
In a patient presenting with haemoptysis, the appearance likely indicates alveolar haemorrhage.
Diffuse alveolar haemorrhage (DAH) is a medical emergency as it can lead to respiratory failure. Causes of DAH are –
- Systemic vasculitis (GPA, Goodpasture’s disease, SLE).
- ARDS due to any cause.
- Medications – anticoagulants, Glycoprotein IIB IIIA inhibitors.
- HIV with Kaposi sarcoma
- Crack cocaine inhalation.
The above patient was stable, was admitted and underwent supportive treatment. Likely cause for their presentation was cocaine snorting. A chest x-ray repeated after 3 days showed complete resolution of the ground glass pattern seen initially.