PMC6500667_01
On day 6, the skin discoloration expanded to above the right knee.
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A streptococci. After day 6, while the skin discoloration expanded to above the right knee (Figure 1), blood tests showed a trend towards improved.
Time course of changes in P-SEP, WBC, CPR, and platelet count.
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On day 14, the patient was transferred from the ICU to our general ward (Figure 2).
Contrast-enhanced CT on day 32.
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Contrast-enhanced CT on day 32 revealed an encapsulated abscess in the right lower leg soleus muscle (Figure 3).
Contrast-enhanced CT on day 50; CT revealed a residual abscess.
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On day 50, CT revealed a residual abscess (Figure 4).
CT on day 100. Swelling was alleviated and disappearance of abscess was confirmed.
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After that, P-SEP gradually decreased and CT confirmed the disappearance of the abscess and swelling on day 100 (Figure 5).
Time course of changes in P-SEP and CPR after the transfer to the general ward. Debridement was performed on day 34. Later, C-reactive protein (CRP) was 0.4-1.1 mg/dL, but P-SEP fluctuated between 350 and 380 pg/mL. On day 50, CT revealed a residual abscess. Therefore, we performed the second debridement on day 60. After that, P-SEP gradually decreased.
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fig6
Oral MINO was discontinued after confirming that the P-SEP level had improved to 88 pg/mL (Figure 6).