case_images: PMC11250576_01
case_images: Computed tomography and endoscopic images. a Computed tomography. b Duodenal mucosa by esophagogastroduodenoscopy. c Small bowel mucosa by capsule endoscopy. d Transverse colon. e Sigmoid colon by colonoscopy. Contrast-enhanced computed tomography revealed severe edema of the colon (green arrows) and intestinal fluid accumulation of the entire small bowel (yellow arrows) (a). Esophagogastroduodenoscopy revealed villous swelling and ring erosions in the duodenal mucosa (b), while no abnormalities were observed in the esophagus or stomach. Capsule endoscopy revealed villous swelling, erosions, and shallow ulceration throughout the small bowel mucosa (c). Colonoscopy revealed a shallow ulceration in the entire colonic mucosa (d, e).
case_images: crg-2024-0018-0001-539413_F01.jpg
case_images: PMC11250576_01_crg-2024-0018-0001-539413_F01.jpg
case_images: F1
case_images: COVID-19 was 114.5 kg (body mass index, 36.5 kg/m2), which decreased to 94.6 kg at the time of readmission to our hospital. Contrast-enhanced computed tomography revealed severe edema of the colon and intestinal fluid accumulation of the entire small bowel (shown in Fig. 1a). Clostridioides difficile. Esophagogastroduodenoscopy revealed villous enlargement and ring-like erosions in the duodenum (shown in Fig. 1b). Capsule endoscopy revealed ring-shaped and multiple map-like ulcerations with villous enlargement in the entire small bowel and duodenum (shown in Fig. 1c). Colonoscopy revealed extensive mucosal edema and multiple shallow map-like ulcerations throughout the colorectal mucosa (shown in Fig. 1d, e).
case_images: Clinical course from administration day. Clinical course since transfer to our hospital, including treatment details, laboratory data (WBC, Hgb, Alb, CRP, D-dimer) changes, and stool volume. WBC, white blood cell; Hgb, hemoglobin; Alb, albumin; RBC, red blood cell concentrate; mPSL, methylprednisolone; GCV, ganciclovir; PSL, prednisolone.
case_images: crg-2024-0018-0001-539413_F02.jpg
case_images: PMC11250576_01_crg-2024-0018-0001-539413_F02.jpg
case_images: F2
case_images: A progress chart is shown in Figure 2.
case_images: Secular change of colonoscopic images. Secular changes in endoscopic images of the sigmoid colon. 2 (a), 18 (b), 30 (c), and 40 (d) days after transfer. Before the initiation of prednisolone treatment, the patient had extensive shallow ulcerations throughout the colonic mucosa (a). After the initiation of mPSL treatment, the ulceration disappeared, although it was susceptible to hemorrhage (b). Thereafter, the mucosal findings gradually improved (c), and the edema disappeared before the patient was transferred (d). mPSL, methylprednisolone.
case_images: crg-2024-0018-0001-539413_F03.jpg
case_images: PMC11250576_01_crg-2024-0018-0001-539413_F03.jpg
case_images: F3
case_images: Secular changes in endoscopic images of the sigmoid colon are presented in Figure 3a-d.