case_images: PMC11163097_01
case_images: The timeline of the patient' disease evolution and treatments. (A) On admission; (B) six days after admission; (C) thirteen days after admission; (D) one month after admission; (E) five months after admission.
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case_images: PMC11163097_01_fmed-11-1373319-g001.jpg
case_images: F1
case_images: The patient received a computerized tomography (CT) scan examination of chest, which revealed multiple solid lesions in both lungs (the largest is about 4 cm in diameter), small pleural effusion in the left thorax, and mediastinal adenopathy (see Figure 1A). CT reexamination was performed, which revealed a markedly enlarged bilateral area of patchy hyperdense opacities, with large patches of ground-glass opacities surrounding the lesions (see Figure 1B). Considering the patient was elderly and that these lesions were solid with burr signs, as well as the progression after antimicrobial therapy cancer was considered in the differential diagnosis. The patient received a chest CT re-examination (see Figure 1C) and a puncture biopsy of the largest lung lesion under CT guidance. Ten days after this treatment, chest CT re-examination was performed, which revealed a reduction in the extent of bilateral lung shadow (see Figure 1D). Subsequent follow-up re-examination of the chest CT showed that the lesions were absorbed in both lungs (see Figure 1E).
case_images: The pus was found in percutaneous lung neoplasm biopsy puncture, which was detected microbes by metagenome next-generation sequencing technology (mNGS).
case_images: fmed-11-1373319-g002.jpg
case_images: PMC11163097_01_fmed-11-1373319-g002.jpg
case_images: F2
case_images: Results of pathogen culture in the pus. (A) Culture original by nutrient agar; (B) oil mirror of pathogenic bacteria by weak anti-acid staining, 1000x.
case_images: fmed-11-1373319-g003.jpg
case_images: PMC11163097_01_fmed-11-1373319-g003.jpg
case_images: F3
case_images: CGAGTCCAGCTGCGCCGAGAGT). Culture of the puncture fluid was positive and displayed dry chalky white colonies (see Figure 3).