CTICasesPost-ARDS Tracheal Buckling and Scarring from H1N1 Influenza
Imaging findings
Long-term follow-up chest radiograph 8 years after severe H1N1 influenza ARDS demonstrates severe upper lung predominant scarring, low lung volumes, tracheal buckling, and splaying of the carina. Initial CT during the acute phase showed peripheral ground-glass opacities mimicking COVID-19.
Key takeaways
Severe viral pneumonias like H1N1 influenza and COVID-19 can cause ARDS. Survivors can develop permanent, chronic post-ARDS lung scarring that characteristically favors the upper lobes. This fibrotic scarring leads to volume loss, tracheal deviation/buckling, and carinal splaying over time.
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