case_images: PMC10894044_01
case_images: (a-d) Chest CT images of the patient on admission showing diffuse, unevenly distributed ground-glass opacities throughout both lungs (arrowheads)
case_images: cureus-0016-00000052944-i01.jpg
case_images: PMC10894044_01_cureus-0016-00000052944-i01.jpg
case_images: FIG1
case_images: A high-resolution chest CT scan confirmed diffuse, unevenly distributed ground-glass opacities throughout both lungs (Figure 1).
case_images: Clinical course of the patient. MTX, methotrexate; mPSL, methylprednisolone; PSL, prednisolone; ST; trimethoprim/sulfamethoxazole; LVFX, levofloxacin; CTRX, ceftriaxone; LDH, lactate dehydrogenase; CRP, C-reactive protein
case_images: cureus-0016-00000052944-i02.jpg
case_images: PMC10894044_01_cureus-0016-00000052944-i02.jpg
case_images: FIG2
case_images: Treatment was initiated with discontinuation of MTX, administration of steroid pulse therapy (methylprednisolone, or mPSL, 500 mg), trimethoprim/sulfamethoxazole (TMP/SMX), antibiotics (levofloxacin 500 mg/day and ceftriaxone 2 g/day), and supplemental oxygen; 5000 units of Heparin Ca were administered due to elevated D-dimer levels (Figure 2). On day 3, her respiratory status worsened, necessitating the initiation of high-flow oxygen therapy (Figure 2).
case_images: (a-d) Chest CT images of the patient on day 19 showing complete resolution of the ground-glass opacities
case_images: cureus-0016-00000052944-i03.jpg
case_images: PMC10894044_01_cureus-0016-00000052944-i03.jpg
case_images: FIG3
case_images: On day 19, her chest CT showed complete resolution of the ground-glass opacities (Figure 3), and blood tests indicated decreased inflammatory markers.