case_images: PMC9247387_01
case_images: (A) Chest radiograph (bedside) on first day, showing bilateral middle zone haziness, (B) Contrast enhanced CT (CECT) chest on second day showing bilateral ground-glass opacities in lung parenchyma with (C) left upper lobe consolidation and air bronchogram. (D) Bone marrow biopsy showing hypocellular marrow (overall cellularity < 15%), lacunar spaces extensively replaced by fat cells; the residual cellularity mostly included lymphocytes, plasma cells, mast cells, and macrophages with only a few hematopoietic cells.
case_images: fmed-09-835421-g0001.jpg
case_images: PMC9247387_01_fmed-09-835421-g0001.jpg
case_images: F1
case_images: His ECG showed sinus tachycardia, and the bedside chest radiograph showed bilateral ground-glass opacities (Figure 1A). However, it showed only a consolidation in the left upper lobe and bilateral ground-glass opacities with no evidence of pulmonary embolism (Figures 1B,C). Meanwhile, bone marrow biopsy showed a hypocellular marrow for his age (overall cellularity < 15%), with a possibility of aplastic anemia, malignancy, or an invasive pathology (Figure 1D).
case_images: Showing skin lesions observed on eleventh day of hospital stay. (Arrow): Multiple, erythematous, and non-palpable maculopapular lesions over (A) face, (B,C) palm and dorsum of both hands, and (D) flexor aspect of arms.
case_images: fmed-09-835421-g0002.jpg
case_images: PMC9247387_01_fmed-09-835421-g0002.jpg
case_images: F2
case_images: It was a non-palpable rash measuring 0.5 to 1 cm, on the flexor and extensor aspects of both arms, hands, face, and upper abdomen, suggesting a non-vasculitic but infective etiology (Figure 2).