PMC8277993_01
(A) CT scan taken on February 5 (day 2), showing multiple infectious foci and interstitial lesions in the right lung, the lingual segment of the upper lobe of the left lung, and the subpleura of the lower lobe of the left lung. (B) CT scan taken on February 19 (day 16), 7 days after the patient was weaned from ECMO, showing scattered patchy shadows and meshwork blurred shadows in both lungs, as well as some consolidation, indicative of significant improvements. (C) CT scan taken on February 24 (day 21), after the patient again presented with dyspnea and was re-admitted to the ICU. The CT scan showed patches in lobular segments of both lungs, honeycomb-like changes, partial consolidation, and lesion expansion. (D) CT scan taken on March 01 (day 26), showing patchy, gridded, cellulite-like changes, with bronchiectasis in multiple lobes of the lungs.
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F1
Chest CT showed multiple subpleural infectious lesions in the right lung, and interstitial changes in the lingual segment of the left upper lobe and left lower lobe (Figure 1A). A chest CT taken on February 19 showed significant improvement, and he was discharged to a local hospital for rehabilitation on February 20, 17 days after admission (Figure 1B). The patient was re-admitted to the ICU, and a CT scan on February 24 showed scattered speckled shadows and reticular blurred shadows, with partial consolidation, consistent with infectious interstitial lesions (Figure 1C). Lung CT scan taken on March 1 indicated that the infection was still progressing (Figure 1D).
Detection of pathogens by mNGS.
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F2
Aspergillus fumigatus and Klebsiella pneumoniae, with reads of 80 and 2,325, respectively (Figure 2). A culture of BALF in our hospital also suggested K. pneumonia.
Course of treatment of this patient over time.
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F3
The treatment process is shown in Figure 3.