PMC6812192_01
Chest radiography showed diffuse bilateral infiltrative shadows.
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Chest radiography revealed diffuse bilateral infiltrative shadows (Fig. 1).
High-resolution computed tomography of the chest showed diffuse ground-glass opacities with a crazy-paving appearance.
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High-resolution computed tomography (CT) of the chest showed diffuse ground-glass opacities with a crazy-paving appearance (Fig. 2).
Bronchoalveolar lavage fluid and Berlin blue staining, 40x.
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In cytology, hemosiderin phagocytosis of macrophage was observed by Berlin blue staining (Fig. 3).
Hyperintensity in the right frontal lobe on an axial diffusion-weighted image (DWI).
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We finally made a diagnosis of IE according to the Modified Duke's criteria; 1 important criterion was satisfied (microorganisms consistent with IE from persistently positive 4 separate blood cultures) and more than 3 minor criteria (predisposing heart condition, temperature >38  C, elevated RF, major arterial emboli (Fig. 4)).
Clinical course after hospitalization.
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The patient completed a 6-week course of intravenous ABPC, 2 g every 4 hours, and ceftriaxone (CTRX), 2 g every 12 hours (Fig. 5).