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Chest radiograph on admission. That revealed the lungs were hypolucent bilaterally, with dullness of the costophrenic angle (yellow arrows).
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C-reactive protein concentration was 27.4 mg/dL (reference range, 0.00-0.14 mg/dL); and levels of serum total protein, 5.6 g/dL (reference range, 6.6-8.1 g/dL); albumin, 2.3 g/dL (reference range, 4.1-5.1 g/dL); ferritin, 653.6 ng/mL (reference range, 12-60 ng/mL); procalcitonin, 5.86 ng/mL (reference range, <=0.05 ng/mL); and d-dimer, 15.1 mug/mL (reference range, <=1.0 mug/mL). Chest radiography revealed bilateral consolidation and dullness of the both costophrenic angle(Fig. 1), and chest computed tomography(CT) showed bilateral pleural effusions, which were located in the posterior and basal spaces (Fig. 2).
Follow-up CT on day six after hospitalization. That revealed residual pleural effusion in the right posterior space (yellow arrow), which had increased.
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Follow-up CT showed residual pleural effusion in the right posterior space (Fig. 3).
Follow-up CT on day fifteen after hospitalization. That revealed recurrent right pleural effusion in the right anterior space (yellow arrow).
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A CT scan showed recurrent right pleural effusion in the anterior space (Fig. 4).
Clinical course of the patient. Change over time of white blood cell (WBC) counts, C-reactive protein (CRP) levels, and temperatures are shown. The following antibiotics were administered: MEPM, meropenem; CTM, cefotiam; LVFX, levofloxacin.
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The patient's clinical course, including temperature, laboratory data, and antibiotic therapy is shown in Fig. 5.