PMC9393113_01
Computed tomographic scans of chest and abdomen. (A) and (B) Both lungs showed small scattered nodules and ground glass opacity. (C) A prominent low-density cystic lesion with gas accumulation (97 mm x 75 mm) in the liver (white arrow), which was considered to be ileus on an abdominal radiograph at the community hospital.
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A computed tomographic scan showed multiple nodules in both lungs and intrahepatic cystic lesion with air accumulation (Figure 1), but imaging detected no intestinal obstruction.
Professional medical examination with ophthalmological imaging showed the presence of hypopyon. (A) A color ultrasound image of the eyeball upon admission, with a large volume of pus in the vitreous cavity. (B) Color ultrasound image of the eyeball before enucleation, with extensive pus accumulation in the vitreous cavity, which had worsened significantly. (C) The patient presented with mild swelling of the left eyelid, hyperemia of the eye, mild edema of the left cornea, and an anterior atrial abscess, about 2 mm in depth (white arrow).
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After consultation with an ophthalmologist, he was diagnosed with endogenous endophthalmitis (EE) (Figure 2A and C) and an emergency vitreous injection was performed. The ophthalmologist was consulted again and identified secondary glaucoma (Figure 2B).
A string test was performed to confirm the hypermucoviscous phenotype of the isolated strain. A viscous string of > 5 mm in length was drawn from the colony, in a positive string test.
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Viscous strings from the colonies were both >5 mm in length, indicating positive string tests (Figure 3).