What chest radiograph finding is typical after near-drowning events?

• A. Isolated nodules
• B. No abnormalities
• C. Fluffy infiltrates with pulmonary edema
• D. Large pneumothorax with mediastinal shift

Answer: (C)

Near-drowning commonly causes aspiration of water that injures the airways and the alveolar-capillary barrier, leading to increased capillary permeability and fluid flooding into the alveoli. This produces diffuse interstitial and alveolar edema, which on a chest radiograph appears as fluffy, patchy bilateral infiltrates, often in the perihilar or bibasilar regions. This pattern is characteristic of pulmonary edema from the inflammatory/apneic injury seen after near-drowning.

Isolated nodules would not represent edema or the typical inflammatory pattern; a normal chest radiograph is unlikely after aspiration injury; and a large pneumothorax with mediastinal shift indicates a different, more acute complication (air leakage) rather than edema from drowning.