Fig. 3. 20-year-old immunocompetent man suffering from acute fever and dyspnea.

A. Chest radiograph obtained on fifth day of illness demonstrates focal opacity in left lower lobe (arrow). B, C. Chest CT scans demonstrate dense consolidation and ground-glass opacity in left lower lobe (arrow). Small left pleural effusion is indicated by open arrow. Total CT score was 7. D. Chest radiograph obtained on seventh day of illness demonstrates increased amount of left pleural effusion and bilateral multifocal areas of parenchymal opacity. E. Progressive diffuse opacity in both lungs and bilateral pleural effusions are shown on follow-up radiograph taken on 13th day, suggesting ARDS and type 4 disease pattern. Patient expired on 16th day of illness. ARDS = acute respiratory distress syndrome, CT = computed tomography