case_images: PMC11705991_01
case_images: Longitudinal analysis of temperature change and therapeutic drug. The patient initially received examinations and treatment at Miyun District Hospital during his illness and was subsequently transferred to PLA General Hospital Third Medical Center for inpatient care. Upon the detection of Coxiella burnetii through mNGS, the patient was transferred to Beijing Ditan Hospital. Anti-rejection treatment encompassed the administration of Tacrolimus and Mycophenolate mofetil as drugs. A reduction in the dosage of Mycophenolate mofetil occurred during the treatment. The patient underwent liver protection therapy involving the use of Magnesium Isoglycyrrhizinate and Glutathione. Anti-infection treatment consisted of the administration of Moxifloxacin and Doxycycline. The line graph depicted the changes in the patient's body temperature.
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case_images: The patient was a 41-year-old male dentist who presented with a sudden onset of fever on September 12, 2023, peaking at 38.9 C (Figure 1). The patient's fever resolved on the second day of admission and did not recur thereafter (Figure 1).
case_images: The patient's laboratory dynamic monitoring indicators. (A) The dynamic monitoring of patient's white blood cells (WBC)(left y-axis) and percentage of neutrophil (NEU%) (right y-axis). (B) The dynamic monitoring of patient's alanine transaminase (ALT) and aspartate aminotransferase (AST). (C) The dynamic monitoring of patient's C-reactive protein (CRP).
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case_images: Laboratory results revealed normal white blood cell (WBC) count and neutrophil percentage (NEU%) (Figure 2A), but an elevated aspartate aminotransferase (AST) level (Figure 2B). On September 16, the patient's C-reactive protein (CRP) level was 29.83 mg/L (Figure 2C), with a WBC count of 6.51 x 109/L and a NEU% of 61.70% (Figure 2A). By September 18, the CRP level had decreased to 22.9 mg/L (Figure 2C), and blood tests showed a WBC count of 8.31 x 109/L, NEU% of 57.5% (Figure 2A), red blood cell (RBC) count of 5.55 x 1012/L, and hemoglobin (HGB) level of 161 g/L. Liver function tests indicated elevated alanine aminotransferase (ALT) at 100.3 U/L and AST at 58.2 U/L (Figure 2B), with other liver function parameters remained normal. At a follow-up visit two months later, laboratory tests revealed a CRP level of 0.23 mg/L, WBC count of 8.26 x 109/L, NEU% of 34.8%, ALT of 25 U/L, and AST of 20 U/L (Figure 2).