PMC8546416_01
Title: Imaging during initial presentation at outside hospital (Day 1). Description: A. Chest x-ray showing interstitial opacities as well as bilateral pleural effusion, right side greater than left. B. Computerized tomography (CT) scan of abdomen showing possibly infected right Bartholin gland cyst. C. Ultrasound of liver showing hepatic abscesses. D. CT scan of abdomen showing hepatic abscesses.
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Imaging at OSH (Fig. 1) included a chest radiography which revealed small bilateral pleural effusions with right side greater than left.
Title: Imaging during initial presentation to our hospital (Day 3). Description: A. Contrasted computerized tomography (CT) of neck, coronal view, which showed no evidence of abscesses or thrombotic disease. B. CT of chest showing nodular foci (red arrow) in right lung concerning for septic emboli. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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CT of the neck (Fig. 2) showed no evidence of abscess formation, and initial CT of chest showed multiple nodular foci throughout the right lung fields, concerning for septic emboli, multifocal pneumonia, and bilateral pleural effusion, right greater than left, with collapse of adjacent lung tissue.
Title: Repeat imaging on Day 10 after thoracentesis was performed. Description: Repeated computerized tomography of chest of the abdomen and pelvis showing A. multifocal pneumonia with nodular opacities in transverse view, B. hepatic abscess in transverse view, C. hepatic abscesses and right vulvar lesion consistent with Bartholin gland cyst in coronal view.
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Repeat CT of chest, abdomen and pelvis (Fig. 3) on day 10 revealed evidence of bilateral multifocal pneumonia with pleural effusions as well as concerns for necrotizing pneumonia or developing pulmonary abscess, the presence of hepatic abscesses, and subcutaneous right perineal region fluid collection concerning for infected Bartholin gland cyst.
Title: Repeat computerized tomography of the abdomen and pelvis with contrast on Day 15. Description: A. thrombosis in right iliac vessels (red arrow) in transverse view, B. thrombosis in right iliac vessels (red arrow) in coronal view. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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The patient additionally had a contrasted CT of her abdomen and pelvis done on day 15 which noted (Fig. 4) a nonocclusive thrombus within the right common iliac vein extending into the internal iliac vein and possible right distal external iliac vein nonocclusive thrombus.