case_images: PMC10440429_01
case_images: Scar from a tick bite on the patient's lower right abdomen.
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case_images: PMC10440429_01_fmed-10-1209174-g0001.jpg
case_images: F1
case_images: Through high-throughput gene detection (NGS) of blood PMseq-DNA, we identified hepatitis B virus (HBV) and rickettsia presence in the samples (Supplementary Table S1, Supplementary Figure S1). The results of the HBV DNA were 9.35*104 IU/ml. The patient has a 0.5 x 0.5 cm2 scar on his lower right abdomen, caused by a mosquito bite that occurred more than 10 days before hospital admission (Figure 1).
case_images: (A) Representative CT images of interlobular septal thickening at chest CT scan of both upper lungs. (B) Bilateral pleural effusions in the lower lungs. (C) The mediastinal window of the chest CT reveals a small amount of pericardial effusion.
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case_images: PMC10440429_01_fmed-10-1209174-g0002.jpg
case_images: F2
case_images: A chest CT scan revealed two inflammatory lung lesions and mild interstitial pulmonary edema (Figure 2A). Additionally, bilateral pleural effusion, lower pulmonary partial atelectasis, and bilateral pleural thickening were observed (Figure 2B). Aortic thickening was also observed, and some fluid was present in the pericardial cavity (Figure 2C). Platelet distribution appeared satisfactory, and no blood parasites were observed (Supplementary Figure S2).
case_images: Illustration of bone marrow staining. (A) Erythrocyte phagocytosis; (B) platelet phagocytosis; (C) granulocyte phagocytosis.
case_images: fmed-10-1209174-g0003.jpg
case_images: PMC10440429_01_fmed-10-1209174-g0003.jpg
case_images: F3
case_images: The bone marrow puncture revealed significantly active proliferation of bone marrow nucleated cells, accompanied by erythrocyte hyperplasia and erythrocyte phagocytosis (Figure 3A). Most of the cells were granulomatous macrophages, and scattered platelet phagocytosis was also observed (Figure 3B). Granulocyte hyperplasia was characterized by immature neutrophils and band-shaped neutrophils (Figure 3C).