Pulmonary - Jellyfish Sign
Caption
A middle age man presented with a subacute dyspnea, orthopnea, non productive cough, and paroxysmal nocturnal dyspnea. Physical exam was notable for bilateral, fine, end-inspiratory crackles over the lung bases; an S3 on cardiac auscultation; and an SpO2 of 92% on 2L nasal cannula. POCUS identified the presence of atelectatic lung in an anechoic large right-sided pleural effusion. The sonographic appearance of atelectatic lung "swimming" within a large pleural effusion is often referred to as “jellyfish sign”. Subsequent laboratory evaluation of the pleural fluid confirmed a transudative effusion secondary to decompensated left-sided heart failure. Al Chalaby, Shahad. PGY3. Highland Hospital. Alameda Health System Internal Medicine Residency Program. @shahad_Chalaby