case_images: PMC11761758_01
case_images: Therapeutic process and changes in CRP levels and complete blood count from admission to discharge. Notes: The red, green, and black dots represent values > upper limit of normal (ULN), < lower limit of normal (LLN), and normal, respectively. Abbreviations: BP, blood pressure; BT, body temperature; CRP, C reactive protein; CTA, computed tomography angiography; ECG, electrocardiogram; HRCT, high-resolution computed tomography; IVIG, intravenous immunoglobulin; LYM, lymphocyte; MONO, monocyte; MRI, magnetic resonance imaging; NEU, neutrophil; PR, pulse rate, RR, respiratory rate; SFTSV, severe fever with thrombocytopenia syndrome virus; VATS, video-assisted thoracoscopic surgery; WBC, white blood cell
case_images: 12879_2025_10503_Fig1_HTML.jpg
case_images: PMC11761758_01_12879_2025_10503_Fig1_HTML.jpg
case_images: Fig1
case_images: The therapeutic process, changes in the levels of C-reactive protein (CRP) levels and complete blood count are depicted in Fig. 1.
case_images: (A) Echocardiography: The vegetation (2.68 x 1.63 cm) was detected at the junction of the posterior-lateral edge of the anterior papillary muscle and the left ventricular lateral wall, the base (1.13 cm) was attached to the endocardium of the lateral wall. The lobulated distal portion moved with the cardiac cycle. (B) Transesophageal echocardiography: Several hypoechoic vegetations were detected on the anterior papillary muscle of the left ventricle, with the largest measuring 1.6 x 1.4 x 1.1 cm. The base was fixed to the papillary muscle, and it moved with the cardiac cycle. (C) Pathology of vegetations by hematoxylin and eosin stain. (D) Identification of Aspergillus by fluorescent in situ hybridization. (E) Electrocardiogram: atrial fibrillation with rapid ventricular rate. (F) Abdominal computed tomography angiography: right kidney with ischemic infarction and spleen with subcapsular infarction. (G) High-resolution computed tomography: Crescent signs and nodules in the lungs
case_images: 12879_2025_10503_Fig2_HTML.jpg
case_images: PMC11761758_01_12879_2025_10503_Fig2_HTML.jpg
case_images: Fig2
case_images: Digitalis and metoprolol were administered due to the AF with a rapid ventricular rate (Day 4) (Fig. 2), but were withdrawn due to the bradycardia (Day 6). Abdominal computed tomography angiography revealed infarctions in the right kidney and spleen (Fig. 2). Therefore, the chest high-resolution computed tomography scan was performed on Day 22, and showed crescent sign and multiple nodules in both lungs (Fig. 2). The echocardiogram was conducted and showed left atrial enlargement (5 x 6 cm), left ventricular hypertrophy (Wall thickness: 1.6 cm), and the vegetations in the left ventricle (Fig. 2) (Supplementary material 1).
case_images: Multiple signal abnormalities in the bilateral cerebellum, frontal, temporal, parietal, occipital lobes, and corpus callosum. (A) T2-weighted imaging. (B) T1-weighted imaging. (C) T1-weighted contrast-enhanced imaging: the abscess with a diameter of 13.1 mm, surrounded by a hyperintense ring with peripheral patchy hypointensity. (D-F) Axial T2-propeller imaging: the abscess following stroke on day 0, day 21, day 35
case_images: 12879_2025_10503_Fig3_HTML.jpg
case_images: PMC11761758_01_12879_2025_10503_Fig3_HTML.jpg
case_images: Fig3
case_images: Brain MRI showed abscess and multiple signal abnormalities (Fig. 3).