PMC6304869_01
Levels of neutrophil CD64 elevated with dissociation of a CRP change (case 1). The cutoff value for the levels of neutrophil CD64 was 2000 molecules/cell.
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fig1
In April 2010, intravenous administration of vancomycin or teicoplanin (TEIC) improved the aforementioned symptoms (Figure 1).
Computed tomography scan images of case 1. Particulate lesions diffusely observed in both lung fields (a) were diminished after antituberculosis therapy (b); cystic lesion with the same absorption range as abscess observed in paraspinal muscle (c) was also diminished after antituberculosis therapy (d).
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fig2
Whole-body computed tomography (CT) revealed diffuse small granular shadows on both lungs and fluid accumulations (abscess) around the lumbar vertebrae Figures 2 and 2. September 2010, after treatment for TB, the levels of neutrophil CD64 decreased below the cutoff value (<2000 molecules/cell) and abnormal findings on the CT scan disappeared Figures 2 and 2. Sustained high levels of neutrophil CD64 were considered to be due to reactivation of LTBI.
PMC6304869_02
Levels of neutrophil CD64 increased even after antibiotic therapy (case 2).
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fig3
In May 2011, treatment with antibiotics was associated with slight fever, elevated serum CRP, and continuous elevation of neutrophil CD64 (up to 18,831 molecules/cell) (Figure 3).
(a) Chest CT scan image at the time of admission. Diffuse particulate shadows are shown in the whole-lung field at random; (b) noncaseating epithelioid granuloma was observed in bronchial and alveolar specimens obtained through bronchoscopy (hematoxylin and eosin (H & E) stain; magnification x400); (c) a cellulitis-like lesion on the patient's right lower limb; (d) biopsy specimens from cellulitis also revealed erythema induratum of Bazin (H & E stain; magnification x400) (case 2).
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fig4
ADA was discontinued and further examination revealed diffuse reticulonodular shadows in the lung fields through chest X-ray and CT scan, suggesting the development of miliary TB (Figure 4). Noncaseating epithelioid granuloma was observed in bronchial and alveolar specimens obtained through bronchoscopy (Figure 4). Biopsy specimens from a cellulitis-like lesion on the patient's right lower limb (Figure 4) also revealed erythema induratum of Bazin (Figure 4).
PMC6304869_03
High levels of neutrophil CD64 were maintained since admission to the hospital (case 3).
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fig5
The levels of serum CRP were approximately 1 mg/dl, and the levels of neutrophil CD64 were highly elevated (up to 11,387 molecules/cell) (Figure 5).
(a, b) Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging of the brain revealed pia-subarachnoid enhancement (case 3).
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fig6
A pia-subarachnoid enhancement was found on the fluid-attenuated inversion recovery (FLAIR) sequence, which was compatible with meningitis (Figure 6).