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case_images: Sputum sample test. (a) Gram staining of the sputum sample. (b) Modified acid-fast staining of the sputum sample. (c) White dry colonies on blood agar plate.
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case_images: Actinomycetes (Figure 1a and b). All sputum specimens submitted for examination were deep purulent sputum expectorated by patient after thorough mouth rinsing. The sputum culture on day 4 of incubation grew Nocardia otitidiscaviarum (Figure 1c).
case_images: Blood sample test. (a) White dry colonies on blood agar plate. (b) White dry colonies on chocolate agar plate. (c) The patient's serum sample: RBT showing positive. (d) The control's serum sample: RBT showing negative.
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case_images: A positive culture result for Brucella was obtained by blood culture on day 5 (Figure 2a and b), which was later confirmed by Rose Bengal plate agglutination test (RBT) (Figure 2c) and mass spectrometric detection and turned out to be Brucella melitensis.
case_images: Chest CT scan. (a) CT scan on March 15th (day 1) showed occupying lesions in the RLL, multiple nodules in both upper lobes. (b) CT scan on March 23rd (day 9). (c) CT scan on April 1st (day 18) showed that lesions occupying both the RLL and multiple nodules in upper lobes shrank obviously. (d) CT scan on May 12th (day 59). (e) CT scan on Jun 18th (day 96). (f) CT scan on August 27th (day 166) showed almost complete absorption of lesions in both lungs.
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case_images: Chest computed tomography (CT) was performed and showed occupying lesions in the right lower lobe (RLL), multiple nodules in both upper lobes, miliary nodules in both lungs, and bilateral pleural effusion (Figure 3a). In addition, the follow-up chest CT on day 9 (Figure 3b) showed no significant differences compared to previous results. On day 18, the chest CT (Figure 3c) showed that lesions occupying both the RLL and multiple nodules in upper lobes shrank obviously, and blood cultures on day 21 and day 25 were both negative. At the fifth month follow-up, the nodules on chest CT disappeared entirely (Figure 3f).