case_images: PMC11370755_01
case_images: (A) A Microscopic examination of sputum smears with Gram stain. (B) Microscopic examination of sputum smears with weak acid-fast stain. (C) Colony morphology observed on blood agar plates after 48 hours of incubation. (D) Gram stain microscopic examination of direct smears of bacterial colonies.
case_images: IDR-17-3777-g0001.jpg
case_images: PMC11370755_01_IDR-17-3777-g0001.jpg
case_images: f0001
case_images: Gram stain of sputum smear: Gram-positive bacilli; sputum culture: Nocardia terpene (Figure 1A-1D).
case_images: Chest CT imaging changes of the patient. (A-C) The imaging result on March 30 shows the both lung fields was showing mosaic changes, interstitial thickening, solid nodules, ground glass nodules. The right lung There were pleural effusion and flake-like high-density shadows with cavities inside. Striped shadow in the left upper lung. (D-F) The imaging result was on April 3. (G-I) The imaging result after 2 days after treatment (April 25). (J-L) The imaging result after treatment (June 7). (M-O) The imaging result after treatment (August 17) shows that the Lesion was further reduced.
case_images: IDR-17-3777-g0002.jpg
case_images: PMC11370755_01_IDR-17-3777-g0002.jpg
case_images: f0002
case_images: An arc-shaped watery density shadow was seen on the right side of the chest (Figure 2A-2C). Chest CT showed that the cavity in the lesion in the lower lobe of the right lung was more obvious than before (Figure 2D-2F). Repeat chest CT showed that the nodular, patchy, and cord-like high-density shadows in both lungs were reduced compared with before (Figure 2G-2I).     A follow-up chest CT on June 7 showed a reduction in nodular, patchy, and cord-like high-density shadows in both lungs, as well as absorption of high-density lesions and effusion in the right pleural cavity (Figure 2J-2L). Methylprednisolone and cyclosporine were then discontinued (Figure 2M-2O).
case_images: (A and B) Bronchoscopy showed congestion and edema in the mucosa of the basal segment of the right lower lobe.
case_images: IDR-17-3777-g0003.jpg
case_images: PMC11370755_01_IDR-17-3777-g0003.jpg
case_images: f0003
case_images: Fiberoptic bronchoscopy showed congestion and edema in the posterior basal mucosa of the right lower lobe (Figure 3).
case_images: (A and B) Red and scattered rash on the patient's neck and chest.
case_images: IDR-17-3777-g0004.jpg
case_images: PMC11370755_01_IDR-17-3777-g0004.jpg
case_images: f0004
case_images: Painful ulcers appeared on the tongue and tip of the tongue, and red rashes were scattered on the neck and chest (Figure 4).