PMC5478576_01
Head CT scan images without contrast enhancement. Non-enhanced CT of the brain showed subarachnoid hemorrhage in the left frontotemporal portion.
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Head CT showed subarachnoid hemorrhaging (Fig. 1), and brain MRI showed multiple cerebral emboli in the left hemisphere (Fig. 2).
Chest CT scan image with contrast enhancement. Contrast-enhanced CT scan performed on admission showed embolus in proximal area of the left common carotid artery. First contrast-enhanced computed tomography (CT) scan performed on admission 4 months ago did not have increased soft tissue densities around the artificial graft and second contrast-enhanced CT scan performed on admission revealed ectopic increased soft tissue densities around the artificial graft suggesting a prosthetic graft infection.
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Chest CT revealed increased soft-tissue density around the artificial graft, with thrombus formation in the proximal area of the left common carotid artery (Fig. 3).
Clinical course of the patient.Candida albicans was detected in 2 blood culture bottles from the repetition collected total 15 blood culture bottles. Although we had switched from ABPC/SBT to FLCZ on day 35, inflammatory reaction was not improved. Moreover, we had switched to L-Amph on day 42 because of lack of clinical effectiveness and newly emergent liver dysfunction. Consequently, inflammatory reaction improved.
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Despite the treatment effort, the patient's condition gradually deteriorated, resulting in his death (Fig. 4).