Chest radiograph of a child with fulminant viral myocarditis

Anterior-posterior chest radiograph of a child with fulminant viral myocarditis. The child was a previously healthy 9-year-old girl who presented with progressive orthopnea, cough, and respiratory distress following 2 weeks of a viral prodrome. Chest radiograph demonstrates bilateral lung opacities, sizable bilateral pleural effusions, and borderline cardiomegaly. The child presented in severe distress and suffered cardiopulmonary arrest shortly after arrival to the emergency department. Management included inotropic support, diuretic therapy, placement of bilateral chest tubes, and intravenous immune globulin. She subsequently made a full recovery.