A 69-year-old patient presented to the Emergency Department (ED) with a productive cough, fever, and shortness of breath. In the ED, diagnostic tests were obtained, including the chest x-ray below. All diagnostic tests are awaiting final reports. [The patient is new to the hospital system, and no previous chest x-ray is present in the electronic medical record (EMR) for comparison.] The patient was admitted to the hospital. Unfortunately, on day two of hospitalization developed acute hypoxemic respiratory failure. The patient was transferred to the Intensive Care Unit (ICU). A chest x-ray was U9Discussion1.PNG obtained in the ICU (see top right image).