Because of significant hypoxemia and lung auscultation findings, thoracic ultrasound was performed. This showed bilateral focal B-lines, consistent with interstitial syndrome. B-lines are characterized as discrete laser-like vertical hyperechoic lines that arise from the pleural line, extend to the bottom of the screen without fading, and move synchronously with pleural sliding. B-line predominance is defined by the presence of three or more B-lines in a longitudinal plane between two ribs. Diffuse interstitial syndrome is found in cardiogenic pulmonary edema, interstitial pneumonia, acute lung injury, and diffuse parenchymal lung disease. Focal/multifocal B-lines may be seen in the presence of many lung diseases (eg, pneumonia, pulmonary contusion, atelectasis, pulmonary infarction, parenchymal microabscesses, and cavitations), as was in our case. The characteristics of the pleura itself may also be important. Emerging data suggest that infectious or inflammatory lung disease will reveal a “coarse” pleural surface vs the characteristically smooth pleura seen with B-lines secondary to congestive heart failure7 (Fig 4). Video 3 reveals focal B-lines in multiple areas of the examined lungs and is suggestive of septic emboli producing cavitary lesions and microabscesses in light of the clinical information and in the presence of a documented thrombus in IJV. Video 4 clearly shows within the same scanning field an area of normal pleural and A-lines next to an area of irregular pleural surface and B-lines. The irregular pleura is immediately adjacent to an area of echogenicity and lucency, consistent with subpleural small abscess formation and microcavitation. This highlights the focal nature of the process.