Fourty-four-year old male with Pneumococcal pneumonia. (a) Initial chest radiograph (CXR) in emergency department. (b) CXR four hours later after four liters of crystalloid (patient now intubated). (c) CXR 12 hours after admission, after 9 liters of crystalloid, central venous pressure (CVP) = 10 mmHg. Patient died six hours later of refractory hypoxemia.