PMC9720054_01
Down-trending ferritin levels after hospital admission.
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F1
However, a moderate predictive score with normal triglycerides and down-trending ferritin levels delayed the definitive diagnosis (Figure 1).
Chest CT after ICU admission. Description: Bilateral multifocal irregular patchy and confluent ground glass and consolidative opacities with associated predominantly bilateral lower lobe irregular reticulations. Small (right) and trace (left) pleural effusion. CT, computerized tomography; ICU, intensive care unit.
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F2
I gM and negative IgG. In addition, chest CT showed bilateral multifocal pneumonia, that had progressed from her prior imaging during COVID admission (Figure 2).
Flow chart of significant clinical events and outcomes. SARS, severe acute respiratory syndrome; COVID-19, coronavirus disease 2019; RT-PCR, reverse transcriptase polymerase chain reaction; SOB, shortness of breath; AST, aspartate transaminase; ALT, alanine transaminase; VRE, vancomycin resistant enterococcus; ICU, intensive care unit; HSV-1, herpes simplex virus 1; IV, intravenous; Hg, hemoglobin; WBC, white blood cells; HLH, hemophagocytic lymphohistiocytosis.
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F3
Given the poor prognosis, the family made the decision to transition to comfort measures and on hospital day 11, patient expired (Figure 3).