case_images: PMC11260673_01
case_images: Radiological examination of the patient. (A,B) Chest CT on 49 days after HSCT and 81 days after HSCT. (C-F) Craniocerebral enhanced MRI and brain CT on 49 days after HSCT and 81 days after HSCT.
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case_images: The lower lobes of both lungs were characterized by lamellar consolidation with obvious interstitial changes (Figure 1A). CT results, the lesions and interstitial changes in the lungs were aggravated (Figure 1B). Compared to 49 days after HSCT, the craniocerebral MRI with contrast and brain CT showed abnormal signals in the cortex and subcortical regions of both cerebral hemispheres, as well as in the anterior and posterior corners of both cerebral ventricles, notably in the bilateral frontal lobe and the right temporal lobe. A nodular abnormal signal was noted in the right frontal white matter area, the cerebral sulci and fissures were widened and deepened, and the bilateral lateral ventricles were widened, indicating brain atrophy changes (Figures 1C-E).
case_images: Morphological characteristics of Fusarium solani. (A) After 4 days of blood cultivation, oval fungal spores could be observed by microscope after Gram staining (magnification 10 x 100). (B) The morphology of Fusarium solani on SDA after 96 h of culture. (C-F) The morphologies of Fusarium solani were observed using a KOH fungal smear test (magnification 10 x 100), Gram staining (magnification 10 x 100), lactic acid phenol cotton blue staining (magnification 10 x 40), and fungal fluorescent staining (magnification 10 x 100).
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case_images: The blood cultures showed a positive result after 4 days of culture, and oval fungal spores were observed under a microscope after Gram staining (Figure 2A), which supported our decision to initiate antifungal treatment. The colony morphology on SDA is shown in Figure 2B; the colony exhibited dense, smooth, white mycelium, and the reverse color was reddish in the center and yellow in peripheral areas. The macroconidia were fusiform, cylindrical, moderately curved, and three or four septate (Figures 2C-F).
case_images: Dynamic monitoring of G and GM tests on 3, 7, 38, 49, 81, 94, and 116 days after HSCT.
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case_images: fig3
case_images: Pulmonary CT scans indicated a fungal infection, with the G test showing positive results multiple times and the GM test remaining negative (Figure 3).