Infectious Diseases in Critical Care Medicine

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alternate diagnoses and for interpretation of V/Q scans, to correlate with abnormal areas of
perfusion or ventilation (37).


Lupus Pneumonitis
Pulmonary manifestations of SLE include acute lupus pneumonitis and chronic interstitial
disease. The former is rapid in onset and may mimic a focal pneumonia, with CT findings of
ground-glass attenuation and consolidation that then coalesces (Fig. 22). Additional
radiographic findings include elevated hemidiaphragms due to myopathy and resultant low
lung volumes with linear bibasilar atelectasis. The opacities will respond to steroids, unlike
pneumonia and chronic interstitial disease (37,39).


Congestive Heart Failure
Congestive heart failure (CHF) is usually bilateral and symmetric, but unilateral disease can
also occur much less commonly. A specific condition associated with pulmonary edema


Figure 19 (A) Axial CT image of the brain in a 15-year-old female with known multiple sclerosis demonstrates
a low-attenuation “mass” in the right frontal lobe with little mass effect relative to the size of the lesion.
(B) T2-weighted axial MR image demonstrates high signal intensity within the lesion. (C) Gadolinium-enhanced
T1-weighted axial MR image demonstrates partial rim enhancement in this patient with tumefactive multiple
sclerosis.


Radiology of Infectious Diseases and Their Mimics in Critical Care 93

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