case_images: PMC9426957_01
case_images: Chest X-ray at initial presentation: anteroposterior (A) and lateral (B) views
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case_images: PMC9426957_01_3423_Fig2.jpg
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case_images: A 40-year-old man was referred to our pulmonology department because of an aberrant chest X-ray (Fig. 2).
case_images: HRCT of the lungs at initial presentation
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case_images: PMC9426957_01_3423_Fig3.jpg
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case_images: High-resolution computed tomography (HRCT) revealed bilateral randomly distributed millimetric nodules (Fig. 3).
case_images: HRCT after 4 weeks of treatment with prednisone showing diffuse bilateral consolidations
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case_images: HRCT showed progression with the formation of consolidations (Fig. 4).
case_images: Histological analysis shows the presence of fungal hyphae (A, indicated with a white arrow) and a granuloma (B)
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case_images: This demonstrated extensive inflammation with granulomas and the presence of fungal hyphae (Fig. 5).
case_images: Flow cytometric dihydrorhodamine (DHR) 123 assay results in our patient (A) and a healthy control (B). Y-axis indicates neutrophil cell count, x-axis indicates fluorescence intensity of neutrophils. (A) Left: The MFI (mean fluorescence intensity) of non-stimulated neutrophils is 1.960. Middle: The MFI of unstimulated neutrophils probed with the DHR123 dye. Right: By stimulation of phorbol myristate acetate (PMA) neutrophils produce superoxide radicals resulting in the oxidation of DHR123 to fluorescent R123. The MFI of neutrophils stimulated by PMA is 1.945. This indicates deficient neutrophil oxidizing activity. (B) Left: The MFI of non-stimulated neutrophils is 1.677. Middle: The MFI of unstimulated neutrophils probed with the DHR123 dye. Right: The MFI of neutrophils stimulated by PMA is 150.275. This indicates normal oxidation and fluorescence of DHR 123 by the neutrophils.
case_images: 3423_Fig6.jpg
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case_images: A DHR 123 test in the haematological department was arranged and was positive for CGD (Fig. 6).