case_images: PMC10536161_01
case_images: Bedside chest radiography. Diffuse infectious foci in both lungs with a slight bilateral pleural effusion.
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case_images: Her bedside chest radiograph showed diffuse infectious foci in both lungs with a slight bilateral pleural effusion ( Figure 1 ).
case_images: Endoscopy of the lower gastrointestinal tract. (A) Multiple ulcers with active bleeding in the terminal ileum. (B) Argon plasma coagulation and hemoclip therapy in the terminal ileum. (C) Multiple ulcers in the rectum. (D) Anal fistula.
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case_images: There was no active bleeding on the gastroscopy, while the colonoscopy revealed multiple hemorrhagic ulcers in the terminal ileum ( Figure 2A ), as well as ulcers in the rectum ( Figure 2C ) and anal fistula ( Figure 2D ). Argon plasma coagulation and hemoclip therapy ( Figure 2B ) were performed so that the gastrointestinal bleeding was resolved with a significant improvement.
case_images: Chest and abdominal CT scan images. (A-C) Multiple infectious foci in both lungs and bilateral pleural effusion on 17 February 2023. (a, b, c) Multiple infection foci in both lungs were reduced on 6 March 2023. (i, ii, iii) Clearly decreased foci in both lungs on 28 April 2023.
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case_images: Her chest and abdominal CT showed multiple infectious foci and miliary nodules, considering tuberculosis and bacterial pneumonia, bilateral pleural effusion ( Figures 3A-C ), a low-density lesion in the left lobe of the liver, suspecting hepatic abscess, and slightly high-density and gas-accumulated lesions in bilateral adnexal and subcutaneous encapsulated effusion in the left lower back, considering tuberculosis cold abscess. She underwent chest and abdominal CT on 6 March 2023, and, encouragingly, the multiple infection foci in both lungs and subcutaneous effusion in the left lower back were reduced ( Figures 3a-c ). Constructive follow-up is still ongoing, with an obvious absorption of lesions on bilateral lungs in the second month ( Figure 3i-iii ), and we will adjust the anti-tuberculosis regimen based on the therapeutic efficacy and adverse effects of the patient.
case_images: Treatment and observation during hospitalization. (A) Monitoring of body temperature and treatment. (B) Counting of white blood cells and lymphocytes. (C) Level of aspartate aminotransferase and alanine aminotransferase.
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case_images: The patient responded well to the treatment, with marked improvement in fever and lymphopenia ( Figures 4A, B ). After receiving liver function-protecting treatment containing bicyclol and ademetionine, her transaminase recovered to a normal level ( Figures 4A, C ).