PMC6161692_01
Chest x-ray, prior to commencing treatment.
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F1
HRCT evidence of progressive bronchiectasis (see Figures 1, 2), growth and development was excellent (Weight and height 64th centile) with baseline FEV1 3.8 l (93.9%). He had previously cultured Staphylococcus aureus (SA) and PsA (non-mucoid) and had one admission in the previous 12 months, requiring a pulmonary optimization with intravenous Piptazobactam and Tobramycin following a period of wet cough and decline in lung function.
High resolution CT chest with contrast. Generalized bronchiectasis demonstrated.
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F2
HRCT evidence of progressive bronchiectasis (see Figures 1, 2), growth and development was excellent (Weight and height 64th centile) with baseline FEV1 3.8 l (93.9%). He had previously cultured Staphylococcus aureus (SA) and PsA (non-mucoid) and had one admission in the previous 12 months, requiring a pulmonary optimization with intravenous Piptazobactam and Tobramycin following a period of wet cough and decline in lung function.
MRI, coronal section of right ankle, T1 weighted image.
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F3
He was referred to an orthopedic specialist in a near-by provincial center where an MRI identified a suspected tumor in his distal tibia (see Figure 3).
PMC6161692_02
PMC6161692_03
AP x-ray of right lower leg, cannulated screws transfix the fibular bone graft to the distal right tibial diaphysis.
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F4
Four months after diagnosis he underwent distal tibial resection and free fibula flap reconstruction (see Figure 4) which he recovered well from, requiring repeat bone graft to the right tibia 6 months later.
Percentage of predicted FEV1 at baseline, diagnosis, during chemotherapy and 12 months following completion.
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F5
Pulmonary function improved during his treatment from baseline (see Figure 5) with FEV1 4.15 l (102.3% predicted) whilst nutritional status remained stable with weight 64.1 kg (62nd centile).
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