case_images: PMC11439622_01
case_images: Clinical data of patients. (A) The PET/CT scan (taken in late February 2023) showed a soft tissue mass adjacent to the left side of the esophageal hiatus and above the retroperitoneal abdominal trunk, exhibiting increased FDG metabolism. (B) The ECG (taken in early June 2023) revealed mild ST segment depression in leads V5 and V6 (marked by the green arrow) and T-wave changes (indicated by the blue arrow), premature atrial contractions, short strands of atrial tachycardia, and premature ventricular contractions. (C) The blood smear examination (taken in late June, 2023) indicates a left shift in neutrophil nuclei.
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case_images: Figure 1A ). From March to April 2023, he received three cycles of nab-paclitaxel (300 mg at Day 1), and sintilimab (Innovent Biologics Inc.) (200mg at Day 1). A repeat ECG revealed mild ST-segment depression and T wave changes, premature atrial contractions, short strands of atrial tachycardia, and premature ventricular contractions ( Figure 1B ). The blood smear indicated infection, evidenced by left shift of nucleus ( Figure 1C ).
case_images: Changes in biochemical markers. (A) Levels of Troponin I before and after methylprednisolone treatment. When the MPS dose was adjusted to 120mg/d, cTnI showed a brief decrease, but then increased again. When the MPS dose was 1000mg/d, it was found that cTnI significantly decreased, and as the MPS dose decreased, cTnI did not rebound and gradually returned to normal levels. (B) Levels of PCT and CRP before and after antibiotic therapy. With the adjustment of antibiotics, the inflammatory markers CRP and PCT of the patient gradually decreased. However, discontinuation of medication during discharge led to a further increase in inflammatory markers, which were reduced when antibiotics were reused. cTnI, cardiac troponin I; MPS, methylprednisolone; d, day. PCT, procalcitonin; CRP, C-reactive protein; po, per os; q8h, every 8 hours; q12h, every 12 hours; SMZ, compound sulfamethoxazole tablets; ETP, ertapenem; TIENAM, imipenem and cilastatin sodium; MEPM, meropenem; SCF, sulbactam and cefoperazone; TZP, piperacillin sodium and tazobactam sodium; FCZ, fluconazole.
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case_images: His cTnI decreased to 0.169 mug/ L ( Figure 2A ). His PCT level decreased to 0.12ng/ml, and his CRP decreased to 17.6mg/L ( Figure 2B ).
case_images: The treatment chart of the patient. nab-PTX, nab-paclitaxel; NDP, Nedaplatin; c, cycle; PET/CT, positron emission tomography/computed tomography; ICI, immune checkpoint inhibitors; MPS, methylprednisolone; d, day; po, per os; q8h,every 8 hours;q12h,every 12 hours;SMZ, compound sulfamethoxazole tablets; ETP, ertapenem; TIENAM, imipenem and cilastatin sodium; MEPM, meropenem; SCF, sulbactam and cefoperazone;TZP, piperacillin sodium and tazobactam sodium; FCZ, fluconazole.
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case_images: PMC11439622_01_fonc-14-1465395-g003.jpg
case_images: f3
case_images: After more than one month of follow-up, the patient reported no significant discomfort.  Figure 3  provides a summary the treatment for this patient.