PMC9984921_01
Changes in white blood cell (WBC) count, neutrophil count and percentage, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) at different time points.
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C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) all increased in varying degrees during the illness (Figure 1); the following microbial culture of ear secretion was done: Aspergillus flavus (++++), Klebsiella pneumoniae (++); positive serum galactomannan antigen test (GM test) result (0.84 > 0.5). Computed tomography (CT) scan showed opacification of his left mastoid air cell system and middle ear, as well as extensive bone erosion and destruction of temporomandibular joint, petrosal apex, occipital condyle, and zygoma (Figure 2). Erythrocyte sedimentation rate and C-reactive protein levels were significantly decreased (Figure 1).
Computer tomography of the temporal bone in case 1, extensive bony destruction of the temporomandibular joint (A, red arrow), petrosal apex (a, orange arrow), occipital condyle (b, blue arrow), and zygoma (c, green arrow).
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C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) all increased in varying degrees during the illness (Figure 1); the following microbial culture of ear secretion was done: Aspergillus flavus (++++), Klebsiella pneumoniae (++); positive serum galactomannan antigen test (GM test) result (0.84 > 0.5). Computed tomography (CT) scan showed opacification of his left mastoid air cell system and middle ear, as well as extensive bone erosion and destruction of temporomandibular joint, petrosal apex, occipital condyle, and zygoma (Figure 2).
A-C. Positron emission tomography-computed tomography of the patient in case 1. The left zygomatic bone, bilateral temporal bones, part of the skull base, C2, and C3 showed dot-like foci with increased fluoro-2-deoxy-D-glucose uptake (SUVmax: 8.1), and the bilateral distribution was basically symmetrical. The corresponding parts of the computed tomography showed local cortical defects and soft tissue swelling.
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Positron emission tomography scanning ([F] FDG-PET) showed that the left zygomatic bone, bilateral temporal bones, some skull base bones, and cervical vertebrae C2 and C3 presented dot-like foci with increased [F]2-fluoro-2-deoxy-D-glucose ([F] FDG) uptake (Figure 3a-c).
PMC9984921_02