Diffuse Air Space Opacities

Diffuse bilateral confluent air space opacities with air bronchograms may result from alveolar edema, pneumonia, or hemorrhage. Associated findings such as cardiac enlargement and pleural effusions help confirm the diagnosis of congestive heart failure; clinical findings of high fever, elevated white blood count, and productive cough favor pneumonia; and a history of hemoptysis may confirm pulmonary hemorrhage. This appearance is also seen in noncardiac edema from a variety of causes, including near-drowning, drug reactions, or acute respiratory distress syndrome. Pulmonary alveolar proteinosis is one of the few chronic diseases that causes this pattern.