PMC8213123_01
Chest X-ray and contrast-enhanced computed tomography of the abdomen and thorax. (a) Bilateral mild pleural effusion with irregular opacity in the right upper zone in postero-anterior view of chest X-ray. (b) Antro-pyloric growth in the stomach (solid red arrow) on contrast-enhanced computed tomography abdomen. (c) (empty red arrow) Enlarged para-aortic lymph nodes on contrast-enhanced computed tomography abdomen. (d) (solid yellow arrow) Emphysematous changes in the lung fields on contrast-enhanced computed tomography thorax and (empty arrow) pleural effusion
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F1
Chest radiograph revealed bilateral mild pleural effusion with irregular opacity in the right upper zone [Figure 1a]. Contrast-enhanced computed tomography (CECT) abdomen revealed a large polypoidal lesion in the anterior wall of the antero-pyloric region, causing complete luminal obstruction [Figure 1b]. Omental nodes were present with mild ascites [Figure 1c]. Bilateral moderate pleural effusion was seen [Figure 1d].
Microscopic examination of sputum sample. (a) Auramine-stained smear with numerous Cryptosporidium oocysts (x200). (b) Modified Ziehl-Neelsen stain with unevenly stained acid-fast structures (arrow) (x1000)
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F2
In auramine phenol stain, fluorescent circular structures measuring 4-7 mum were observed [Figure 2a]. M. tuberculosis in the culture. Modified Ziehl-Neelsen staining showed circular acid-fast structures measuring 4-7 mum [Figure 2b], which were identified as Cryptosporidium species based on morphological characteristics.