PMC6643105_01
Clinical course of our case. It schematically recorded the selection of antibiotics according to the dynamic changes of CT images and the accompanying complications. In particular, multiple polysized pulmonary nodules with cavitation at different levels were highlighted (both parenchymal and mediastinal windows). The numbers on the X axis denote the day from the admission (Day 1) to the loss of patient (Day 20).
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F1
Free of pulmonary infection (PI) (Figure 1), the patient was discharged one month later with a daily oral dose of 40mg mythelprednisolone. She was immediately given intravenous broad-spectrum antibiotics with dose and form respectively determined by creatinine clearance and CT findings (Figure 1): meropenem and voriconazole (Day 1 to 8), piperacillin sodium/tazobactam sodium and voriconazole with double-dose (Day 9 to 14), cefoperazone/sulbactam and micafungi (Day 15 to 19).
Nocardial brain abscess. On the 18th day after admission, diffusion weighed axial MRI of our patient detected brain abscesses. The lesion had mixed signal intensity with hypointense capsule surrounded by high signal edema zone.
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F2
In short notice thereafter, brain abscess was detected by MRI (Figure 2).