The patient has TRALI or transfusion-related acute lung injury which manifests as respiratory distress, hypoxemia, and bilateral pulmonary infiltrates not due to volume overload. The treatment of choice is respiratory suppo, including mechanical ventilation, as needed. The major risk factor for TRALI is transfusion of any plasma-containing blood products from multiparous female donors. Other complications of transfusions and their treatments include: (1) allergic reactions such as rash and fever--mild reactions are treated with an antihistamine; (2) transfusion-associated circulation overload (TACO) which occurs in patients with underlying hea failure who receive large volume transfusions--the treatment is administration of diuretics; and hemolytic reactions--diagnosis is made by a positive Coombs test and treatment is to stop the transfusion and identify the responsible antigen to prevent future reactions. There is no evidence that the patient has pneumonia or any other indication to perform bronchoscopy or to sta antibiotics.