PMC7461861_01
(A)Abdominal CT plain: the gallbladder enlarged, and gallbladder wall was thickened and blurred. (B) Abdominal CT plain: The appendix cavity thickened, and the widest diameter was ~11 mm. (C) Sequencing of Salmonella yielded a total coverage of 6.33% in the gallbladder tissue by NGS. Number of unique reads, coverage, and depth of the identified pathogen sequences. The obtained sequence information was compared and analyzed with the known microbial database of NCBI gene bank to determine the type and content of microorganisms in the sample. The more segments detected, the more coverage, and the more reliable the result. (D) Sequencing of Salmonella yielded a total coverage of 0.04% in the appendix tissue by NGS. Number of unique reads, coverage, and depth of the identified pathogen sequences.
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F1
The abdominal computed tomography (CT) scan revealed acute cholecystitis and appendicitis (Figures 1A,C). Epstein-Barr virus (EBV, HHV-4) reads of 50 and 43 were also detected in the gallbladder and appendix tissues, respectively (Figures 1B,D).
(A) Histology of gallbladder tissue (hematoxylin-eosin stain, magnification x40); (B) Histology of gallbladder tissue (hematoxylin-eosin stain, magnification x200): Extensive transmural infiltration of neutrophils and mononuclear inflammatory cells with intramural abscess formation (yellow arrow) indicating full-thickness necrosis, which contributed to the pathological diagnosis of severe acute gangrenous cholecystitis. (C) Histology of appendix tissue (hematoxylin-eosin stain, magnification x40): The infiltration of both lymphocytes and plasma cells in the appendix wall, accompanied by hyperplasia of fibrous and adipose tissue in the submucosa, revealing chronic inflammatory changes of appendix. (D) Histology of appendix tissue (hematoxylin-eosin stain, magnification x200): The focal inflammatory cell infiltration of neutrophils in the submucosa (yellow arrow) revealed focal acute changes of appendicitis.
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F2
Postoperative pathology revealed acute gangrenous cholecystitis (Figures 2A,B) and chronic appendicitis with focal acute inflammation changes (Figures 2C,D).