case_images: PMC8334719_01
case_images: At the first visit to a primary care doctor, chest CT showed the new infiltrations in the upper (A) and lower lobes (B) of the right lung. CT: computed tomography.
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case_images: He was diagnosed with community-acquired pneumonia based on the new nodules in the upper and lower lobes of the right lung, and amoxicillin-clavulanic acid combination was administered for 14 days (Fig. 1A and B).
case_images: Chest radiograph of the patient, acquired at the initial visit to our hospital, showing consolidations in the right upper and lower pulmonary fields (A). Chest CT scan of the patient showing worsening consolidations in the upper lobe of the right lung (B), central bronchiectasis, and centrilobular nodules in the lower lobe of the right lung (C). HAM suggests allergic bronchopulmonary aspergillosis evident in the lower lobe of the right lung (D) (arrow). Chest radiograph acquired one month after treatment initiation shows disappearance of consolidations in the right upper and lower pulmonary fields (E). Chest CT image showing a reduction in consolidations and nodules in the upper (F) and lower lobes of the right lung (G). HAM in the lower lobe of the right lung disappeared (H). CT: computed tomography; HAM: high attenuation mucus.
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case_images: Chest radiographs showed abnormal infiltration in the upper and lower fields of the right lung (Fig. 2A). Chest CT showed a nodular shadow in the apex of the right lung, central bronchiectasis, and centrilobular nodules in the lower lobe of the right lung (Fig. 2B and C). In addition, chest CT showed bronchiectasis with mucus plugs, called high attenuation mucus (HAM), which have a density equal to or greater than that of the paraspinal muscles in the mediastinal window setting (Fig. 2D). After one month, the nodular lesions, consolidation, and mucoid impaction showed significant improvement on chest radiographs (Fig. 2E) and CT (Fig. 2F, G, and
case_images: Chest CT, acquired three months after the discontinuation of treatment, demonstrates the increased nodular shadow in the upper lobe (A) and the newly appeared, bilateral, centrilobular nodules in the lingular segments (B, C). After four months of clarithromycin and rifampicin administration, these improved (D-F). CT: computed tomography.
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case_images: Chest CT showed an increased nodular shadow in the upper lobe and newly appeared bilateral, centrilobular nodules in the lingular segments (Fig. 3A-C). After one month, his symptoms and eosinophilia improved, and after four months, the new lesions on chest CT improved (Fig. 3D-F).