case_images: PMC11821417_01
case_images: Bronchoscopy findings: (A,B) mucous plugs observed in the bronchi, (C) bronchial brushing procedure for treatment. Annotation: The bronchoscope is in the close-up mode, magnifying 45 times at a distance of 3 mm from the tip.
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case_images: F1
case_images: Bronchoscopy and bronchoalveolar lavage showed abundant white, thick, and viscous secretions in the right lower lobe bronchus, which were removed using a brush and washed with diluted N-acetylcysteine and saline (Figure 1).
case_images: Pulmonary CT findings on Day 7st of onset.
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case_images: F2
case_images: On the 7th day of the illness, consolidation appeared in the right upper lung, with a subsequent increase in the extent of consolidation in the right middle and lower lung lobes (Figure 2).
case_images: Chest x-ray findings on 21st of onset.
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case_images: F3
case_images: ALT at 37 U/L and AST at 23 U/L levels. Cardiac enzymes: LDH 317 U/L and alpha-HBDH 264 U/L levels were elevated; serum protein analysis showed total protein at 72.1 g/L and albumin at 33.1 g/L. A follow-up chest x-ray revealed a large dense shadow with uneven density in the right middle and lower lobe of the lung, with multiple cystic lucencies visible at the lower margin (Figure 3).
case_images: Pulmonary CT findings on Day 21st of onset.
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case_images: F4
case_images: Subsequent lung CT scan showed significant necrosis in the entire right middle and lower lung lobes (Figure 4).
case_images: Pulmonary CT findings on Day 44st of onset.
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case_images: F5
case_images: On the 44th day of illness, the necrotic foci in the right middle and lower lobes decreased, while compensatory enlargement of the right upper lobe occurred (Figure 5).
case_images: Pulmonary CT findings on Day 72st of onset.
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case_images: F6
case_images: On the 72nd day of illness, further reduction of necrotic lesions in the right middle and lower lobes was observed (Figure 6).
case_images: Chest x-ray findings six months into the course of the illness.
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case_images: F7
case_images: Treatment lasted approximately 2.5 months, with a follow-up at six months showing minimal residual cystic densities in the right lower lung (Figure 7).