PMC4720805_01
30-year-old male patient with Middle East respiratory syndrome coronavirus infection.. A, B. Initial posteroanterior chest radiograph and abdominal computed tomography (CT) scan were performed in outside hospital on day of admission (6 days after onset of fever). Chest radiograph (A) shows patchy increased opacity (black arrow) in left lower lung zone, retrocardiac area. Axial CT scan (B) shows patchy area of consolidation with air-bronchogram in left lower lobe, which was mainly peripherally located (black arrow). C-E. Follow-up anteroposterior chest radiograph and chest CT scan were taken in outside hospital 4 days after admission (10 days after onset of fever). Chest radiograph (C) shows newly developed patchy area of ill-defined increased opacity in right upper lung zone (black arrowhead) and increased extent of consolidation in left lower lung zone (black arrow). Upper lung CT scan (D) shows multifocal patchy areas of consolidation (white arrows) with ground glass opacity (GGO) halo and nodular GGO lesions (black arrowheads) in both upper lobes, which were mainly slightly peripherally located. Lower lung CT scan (E) shows larger areas of mixed consolidations and GGOs with air-bronchograms (black arrows) in both lower lobes, mainly in dependent area and newly detected focal consolidation in lingular segment of left upper lobe (white arrow). F-H. Last follow-up anteroposterior chest radiograph and chest CT scan were performed on day of discharge (13 days after admission to our hospital; 23 days after onset of fever). Chest radiograph (F) depicts markedly decreased extent of previous consolidations in right upper and left lower lung zones but residual small increased opacity in right upper lung zone (black arrowhead) and left lower lung zone (black arrow). Upper lung CT scan (G) shows markedly reduced extent of previous multifocal patchy areas of consolidation and nodular ground-glass opacity (GGO) lesions in both upper lobes, but also demonstrates residual GGO lesions (black arrowheads). Lower lung CT scan (H) demonstrates markedly decreased extent of previous mixed consolidations and GGOs with air-bronchograms (black arrow), and developed traction bronchiectasis (white arrowheads) with volume loss in left lower lobe, which suggested fibrosis.
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F1
The initial chest radiograph, which was taken 6 days after the onset of fever, showed a patchy increased opacity in the left lower lung zone, retrocardiac area (Fig. 1A). CT showed no specific finding in abdominal and pelvic organs; however, a patchy area of consolidation with an air-bronchogram was detected in the left lower lobe of the lung, which was mainly peripherally located (Fig. 1B). Conservative treatment with intravenous fluid was used for abdominal pain. A follow-up chest radiograph, which was taken 10 days after the onset of fever, showed newly developed patchy areas of ill-defined increased opacity in the right upper lung zone and increased extent of the previously detected consolidation in the left lower lung zone (Fig. 1C). A chest CT scan performed on the same day showed multifocal patchy areas of nodular consolidations orgwith ground-glass opacity (GGO) halo and nodular GGO lesions in both upper lobes, which were mainly slightly peripherally located (Fig. 1D). Moreover, this scan also demonstrated increased extent of mixed consolidations and GGOs with air-bronchograms in both lower lobes, mainly in the dependent area (Fig. 1E). The chest radiograph depicted markedly decreased extent of previous increased opacities in the right upper and left lower lung zones (Fig. 1F). The chest CT scan showed markedly decreased extent of previously detected lesions with residual nodules or GGOs in both lungs, and developed traction bronchiectasis within retracted consolidation with volume loss in the left lower lobe, which suggested fibrosis (Fig. 1G, H).