A variety of conditions may present as acute hypoxemic respiratory failure
with bilateral alveolar opacities.
Acute cardiogenic pulmonary edema
Bilateral pneumonia
Diffuse alveolar hemorrhage
Inflammatory or autoimmune conditions
Acute eosinophilic pneumonia — AEP occurs in previously healthy individuals and is characterized by cough, fever, dyspnea, and sometimes chest pain. It can be distinguished from ARDS on BAL specimens by the identification of a large number of eosinophils, typically 35 to 55 percent of all recovered cells. Peripheral eosinophilia may or may not be present [
Pulmonary vasculitis
Cryptogenic organizing pneumonia (COP) — COP may be suspected in patients who present with the symptoms of nonresolving
Acute interstitial pneumonitis (AIP; Hamman-Rich syndrome)
Acute exacerbation of idiopathic pulmonary fibrosis (AEIPF)
Disseminated malignancy — Cancer can disseminate through the lungs (invasive cancer) or lymphatics (lymphangitic spread) so rapidly that the ensuing respiratory failure may be mistaken for ARDS
Differential Diagnosis