A 17-year-old male adolescent presented to his family doctor’s clinic with a 1-week history of shortness of breath, cough, right pleuritic chest pain, and fever. He was working as a landscape gardener. His only past medical history was of mild asthma and one episode of childhood pneumonia. His older sister had died in infancy of pulmonary alveolar proteinosis (PAP), but he and his other siblings had never displayed any signs of the disease. On physical examination, the patient exhibited tachypnea and use of his accessory muscles. Auscultation revealed bronchial breathing on the right side. He was frankly cyanotic, with an oxygen saturation of 66%?on room air. The patient was urgently transported to the nearest emergency department. He was intubated immediately on arrival. He then suffered rapid respiratory, hemodynamic, and metabolic deterioration over the next 24 hours despite broad-spectrum antibiotics, fluid resuscitation, lung-protective mechanical ventilation, prone positioning, and neuromuscular blockers. Venovenous extracorporeal membrane oxygenation was started, with dramatic improvement in oxygenation and lactic acidosis.Question: On reviewing images of lung ultrasonography, what is the most likely diagnosis in this clinical context?Answer: These images show a completely consolidated right lung with dynamic air bronchograms (Video 1
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