Jul2 04.24.jpg (109492 bytes)
June 2		 Jul4 16.27.jpg (98668 bytes)
June 4    16:27		 July_5_09.12.jpg (149115 bytes)June 5    01:40 Image 34: A young woman just back from West Africa presented on June 2nd  with fever and a 1.7% P. falciparum parasitemia which was treated with quinine and doxycycline. Her parasitemia had dropped to 0.5% on July 4 but she was still febrile and developing a shortness of breath.  The diagnosis was

 

 

 

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Image 34: Adult respiratory distress syndrome (ARDS). On admission to the ICU she required 100% O2 to maintain her oxygen saturation, but BIPAP with 50% O2 over 48 hours was sufficient to carry her through. Her mentation and renal function remained normal. Follow up x-rays, in a size sufficient for Powerpoint, are here.