case_images: PMC8575073_01
case_images: Chest CT results on day 1, day 7, and day 14 after admission. (A) Chest CT findings on the first day of admission revealed diffuse pneumonitis throughout the lungs. (B) The patient's chest CT on day 7 showed a worsening of the infection (due to the severity of the disease, the patient could not hold her breath well, so the images were not clear). (C) On the 14th day of admission, the patient's chest CT results showed slight improvement after treatment.
case_images: fpubh-09-729595-g0001.jpg
case_images: PMC8575073_01_fpubh-09-729595-g0001.jpg
case_images: F1
case_images: C; blood pressure, 82/41 mmHg; pulse, 116 beats/min; and saturated oxygen in arterial blood, 91%. Chest CT results showed that extensive blurring in both lungs, and diffuse inflammation of both lungs was considered (Figure 1A). Even more striking was the fact that her chest CT findings worsened (Figure 1B). Her liver function, kidney function (Figure 4), platelet count and infection indexes improved significantly (Figure 3), although her chest CT scans showed that the infection in the lungs had improved only slightly after treatment (Figure 1C).
case_images: Results of the next-generation sequencing of bronchoalveolar lavage fluid. (A) Bronchoalveolar lavage fluid. (B) The results showed that the relative abundance of Tropheryma whipplei was 99.4664%. The number of sequences was 5668. (C) The proportions of bacteria, viruses, parasites and fungi.
case_images: fpubh-09-729595-g0002.jpg
case_images: PMC8575073_01_fpubh-09-729595-g0002.jpg
case_images: F2
case_images: A large amount of white mucous was found in the airway during the procedure, and bronchoalveolar lavage fluid (BALF) (Figure 2A) was obtained for next-generation sequencing (NGS). The gene sequencing results for the pathogenic microorganisms were as follows: the relative abundance of T. whipplei was 99.4664%, and the sequence number was 5,668 (fungi, parasites, chlamydia, mycoplasma, mycobacterium and other types of bacteria were not detected) (Figures 2B,C).
case_images: Dynamic changes in infection indexes and platelet counts in the patient after admission. (A, B) The neutrophil and leucocyte counts decreased significantly 7 days after admission. (C) The serum procalcitonin level continued to decline. (D) The platelet count continued to increase. Eventually, the patient's indicators returned to normal (different colors represent different medications, and the length of the lines represents the duration of treatment with the medication).
case_images: fpubh-09-729595-g0003.jpg
case_images: PMC8575073_01_fpubh-09-729595-g0003.jpg
case_images: F3
case_images: In the following week, we re-examined the patient's laboratory parameters (Figures 3, 4), and the patient's overall performance had slightly improved. Her liver function, kidney function (Figure 4), platelet count and infection indexes improved significantly (Figure 3), although her chest CT scans showed that the infection in the lungs had improved only slightly after treatment (Figure 1C).
case_images: Dynamic changes in liver and kidney function in the patient after admission. After appropriate treatment, the aspartate aminotransferase (A), alanine aminotransferase (B), lactate dehydrogenase (C) and creatinine (D) levels of the patient gradually returned to normal (different colors represent different medications, and the length of the lines represents the duration of treatment with the medication).
case_images: fpubh-09-729595-g0004.jpg
case_images: PMC8575073_01_fpubh-09-729595-g0004.jpg
case_images: F4
case_images: In the following week, we re-examined the patient's laboratory parameters (Figures 3, 4), and the patient's overall performance had slightly improved. Her liver function, kidney function (Figure 4), platelet count and infection indexes improved significantly (Figure 3), although her chest CT scans showed that the infection in the lungs had improved only slightly after treatment (Figure 1C).