CTICasesAmiodarone-Induced Diffuse Alveolar Damage
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Imaging findings
Chest radiography and CT demonstrate rapid, progressive development of diffuse, bilateral ground-glass opacities, crazy paving, and dense consolidations extending to the extreme lung periphery. A focal area of bronchiectasis and bronchiolectasis is present, indicating an organizing phase of lung injury. Following intubation, the patient developed severe barotrauma, characterized by a tension pneumothorax, pneumomediastinum, and subcutaneous emphysema.
Key takeaways
Amiodarone toxicity can manifest as acute diffuse alveolar damage (DAD), developing rapidly within 24 to 48 hours of drug administration. Unlike cardiogenic pulmonary edema, amiodarone-induced DAD often displays peripheral or non-dependent consolidation without peripheral sparing. Progressive respiratory failure, barotrauma, and high mortality are common outcomes in severe cases.
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