A 35-year-old male admitted to the intensive care unit because of respiratory failure. He was diagnosed with severe pneumonia caused by avian influenza H7N9 viral infection. After initial clinical improvement supported by extracorporeal membrane oxygenation (ECMO), the patient's condition worsened with persistent fever, refractory hypoxemia. Chest x-rays and computed tomographies showed areas of consolidation and ground-glass opacification. An open lung biopsy was performed, and a histopathological examination of the specimen was done.

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