PMC7661936_01
(A) patient's chest X-ray ad admission with acute respiratory distress syndrome, (B) bone arrow smear (Pappenheim stain) with hemophagocytosis (arrow), (C) patient's CT-scan after ECMO (day 30): calcified lymph node (arrow), (D) patient's MRI-scan after ECMO (day 42): small hygroma and CNS-miliary tuberculosis.
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F1
Initial imaging with x-ray showed a "white lung" (Figure 1A) and with ultrasound showed hepato- and splenomegaly. Bone marrow biopsy showed a distinct hemophagocytosis upon cytologic evaluation (Figure 1B). Magnetic resonance imaging of the central nervous system showed a miliary TBC and a computed tomography scan of the thorax revealed a calcified, round lesion consistent with TBC (Figures 1C,D).
Course of the patient.
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F2
The decision was therefore made to start veno-venous ECMO immediately after admission of the patient (see Figure 2).