PMC9160770_01
A-B: CT chest with contrast showing cavitary lesions, in right and left upper lobes (red arrows). (For interpretation of the references to colour in this figure, the reader is referred to the web version of this article.)
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Computed tomography (CT) of the chest showed bilateral cavitary lesions located peripheral parts of lung (Fig. 1).
A-B. Diffusion-weighted images of MRI brain. A: left, parietal lobe cystic lesion with peripheral enhancement suggestive hemorrhagic transformation, B: focal left cerebellum lesion consistent with septic emboli.
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Because of altered mental status, a MRI brain with and without intravenous gadolinium was performed and it showed evidence of septic cerebral emboli - a left parietal lobe cystic lesion with surrounding edema suggestive of hemorrhagic conversion (Fig. 2A) and a punctate lesion on the left cerebellum (Fig. 2B).
Skin Findings on physical exam: Left and Right forearm, showing improved scabs from bed bug bite (Black arrows).
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Thorough physical examination revealed several maculopapular erythematous skin lesions on upper extremities which the patient reported as bed bug bites. (Fig. 3) No other lesions including dental caries or foreign objects were identified.