case_images: PMC9720054_01
case_images: Down-trending ferritin levels after hospital admission.
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case_images: PMC9720054_01_fmed-09-1053012-g001.jpg
case_images: F1
case_images: However, a moderate predictive score with normal triglycerides and down-trending ferritin levels delayed the definitive diagnosis (Figure 1).
case_images: Chest CT after ICU admission. Description: Bilateral multifocal irregular patchy and confluent ground glass and consolidative opacities with associated predominantly bilateral lower lobe irregular reticulations. Small (right) and trace (left) pleural effusion. CT, computerized tomography; ICU, intensive care unit.
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case_images: PMC9720054_01_fmed-09-1053012-g002.jpg
case_images: F2
case_images: I gM and negative IgG. In addition, chest CT showed bilateral multifocal pneumonia, that had progressed from her prior imaging during COVID admission (Figure 2).
case_images: Flow chart of significant clinical events and outcomes. SARS, severe acute respiratory syndrome; COVID-19, coronavirus disease 2019; RT-PCR, reverse transcriptase polymerase chain reaction; SOB, shortness of breath; AST, aspartate transaminase; ALT, alanine transaminase; VRE, vancomycin resistant enterococcus; ICU, intensive care unit; HSV-1, herpes simplex virus 1; IV, intravenous; Hg, hemoglobin; WBC, white blood cells; HLH, hemophagocytic lymphohistiocytosis.
case_images: fmed-09-1053012-g003.jpg
case_images: PMC9720054_01_fmed-09-1053012-g003.jpg
case_images: F3
case_images: Given the poor prognosis, the family made the decision to transition to comfort measures and on hospital day 11, patient expired (Figure 3).