Chest auscultation revealed bibasilar
fine crackles and signs of pleural effusion.
Interstitial lung disease was defined as the presence of typical features, such as bibasilar
interstitial fibrosis on a HRCT scan of the chest, along with the restrictive pattern on PFT.
(20) Chest high-resolution computed tomography showed traction bronchiectasis and bibasilar
, subpleural reticular opacities consistent with interstitial lung disease.
The single major criterion is presence of sclerodermatous involvement proximal to the digits, affecting limbs, face, neck, or trunk usually in a bilateral and symmetrical pattern.; the minor criteria are sclerodactyly, digital pitted scars or tissue loss of volar pads of fingertips, and bibasilar
pulmonary fibrosis.4 The diagnosis is based on presence of either the major criterion or at least two of minor criteria.
The patients were divided into mild, moderate, and severe on the basis of a clinical scoring system having six parameters (five of which were related to mucocutaneous system): sclerodactyly, digital pitted scars, pigmentation of the body, digital contractures, short sublingual frenulum, and bibasilar
A chest X-ray showed increased cardiothoracic ratio and bilateral bibasilar
In one case, fine bibasilar
rales suggested pulmonary fibrosis, which was the correct diagnosis, and the patient is now on the lung transplant list.
58 Basilar subpleural fibrosis, Died 7 years after initial diffuse peripheral septal consultation thickening with cystic changes 63 Advanced fibrosis, Died 3 years after initial honeycombing, bullous and consultation cystic lesions 64 Peripheral reticular Died 3 years after initial infiltrates consultation 66 Bibasilar
infiltrates, Died 6 years after initial bibasilar
honeycombing consultation 70 NA Died 4 years after initial consultation 70 NA Alive 81 Mild to moderate subpleural Died 2 years after initial fibrosis with bibasilar
consultation honeycombing Abbreviations: DOE = dyspnea on exertion; NA = not available; SOB = shortness of breath.
Physical examination showed pitting edema in bilateral lower extremities till knees, decreased bibasilar
breath sounds, and jugular venous distension.
Chest CTscan displayed bibasilar
pleural effusions and diffuse consolidations plus ground glass opacities involving all lung fields (Figure 1).
dense consolidations from necrotizing Staphylococcus aureus pneumonia (blue arrows) and cavities secondary to necrotizing S.
Chest X-ray showed bibasilar
airspace disease (Figure 1).