PMC9842781_01
Chest X-ray: Bilateral pneumonia and large right pleural effusion
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Initial chest X-ray revealed multilobar pneumonia and large right-sided pleural effusion (Figure 1).
CT chest/abdomen/pelvis with contrast:Interval progression of bilateral diffuse ground-glass infiltrates suspicious for COVID-19 infection. Bibasilar consolidations are right worse than left.
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Further investigation with a CT of chest/abdomen/pelvis with contrast revealed a large empyema and multiple hepatic abscesses (Figures 2 and 3).
CT chest/abdomen/pelvis with contrast:Interval progression of bilateral diffuse ground-glass infiltrates suspicious for COVID-19 infection. Bibasilar consolidations are right worse than left. Interval decrease in small loculated right pleural effusion compatible with empyema. Trace left pleural effusion
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Further investigation with a CT of chest/abdomen/pelvis with contrast revealed a large empyema and multiple hepatic abscesses (Figures 2 and 3).
MRI head:Brain abscesses in the left thalamus, right parieto-occipital region, and right frontal lobe. The largest of these in the left thalamic and right parieto-occipital regions measure 3.1 and 3.4 cm, respectively. There is moderate associated mass effect and mild hydrocephalus.
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On the day of discharge, the patient lost balance while walking and sustained a fall after which a non-contrast head CT was obtained and identified multiple basal ganglia and right occipital lesions, with a follow-up MRI brain that confirmed ring-enhancing lesions concerning brain abscesses (Figure 4).