PMC9576939_01
Chest CT images revealing pneumonia. (A) CT scans on the first day after admission; (B) CT scans at 72 h after admission; (C) CT scans on the fourth day after transferring out of the ICU; and (D) CT scans after GBS diagnosis and treatment for 5 days.
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F1
C, an oxygen saturation level of 98%, a Glasgow Coma Scale score of five, and a sequential organ failure assessment score of nine. Chest computed tomography (CT) (Figure 1) revealed inflammation in both the lungs, especially in the right lung, which was considered to be due to aspiration pneumonia, local bronchiectasis in the middle lobe of the right lung, and interstitial pulmonary edema in the upper lobe of both lungs. Chest CT (Figure 1) showed progression of pneumonia, and skull CT (Figure 2) showed brain edema due to hypoperfusion. Furthermore, the infection index and chest CT (Figure 1) showed significant clinical improvement.
Skull CT images showing brain edema. (A) CT scans at 72 h after admission; (B) CT scans on the fourth day after transferring out of the ICU.
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F2
Chest CT (Figure 1) showed progression of pneumonia, and skull CT (Figure 2) showed brain edema due to hypoperfusion.
Detection of Klebsiella pneumoniae by qPCR in alveolar lavage fluid samples. NTC, negative control; 1102-12, alveolar lavage fluid sample; PTC, positive control.
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F3
Metagenomic next-generation sequencing (mNGS) of the bronchoscope lavage fluid revealed the abundance of Klebsiella pneumoniae sequence, and the pathogen Klebsiella pneumoniae was confirmed by quantitative polymerase chain reaction (qPCR) (Figure 3).
Diagnosis and treatment timeline of the case.
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F4
The timeline of the patient's clinical course described above is presented in Figure 4.