case_images: PMC7411483_01
case_images: PMC7411483_02
case_images: PMC7411483_03
case_images: (a) Liver parenchyma at autopsy. (b) H&E stained section of the involved liver tissue (600x magnification). (c) Gram stain section of the involved liver tissue illustrating spore-forming Gram-negative rods (600x magnification).
case_images: CRIID2020-1839456.001.jpg
case_images: PMC7411483_03_CRIID2020-1839456.001.jpg
case_images: fig1
case_images: Upon serial sectioning of the liver, 10.0 x 6.0 x 4.0 cm of small (0.1 cm) cystic spaces were located in the inferior portion of the liver; the consistency of the liver in this area was readily compressible, reminiscent of lung parenchyma (Figure 1(a)). Microscopic examination of the liver parenchyma demonstrated focal areas of necrosis, rare areas of acute inflammatory cells, vacuolated hepatocytes, and tissue air spaces (Figure 1(b); H&E section). On tissue Gram stain, copious amounts of Gram-positive rods with spores were present (Figure 1(c)).