PMC10150742_01
Chest CT images of the patient on the 3rd day of admission showed enlarged heart shadow, pericardial effusion, ground-glass opacity and patchy consolidation as well as thickened bronchovascular bundle in bilateral lung.
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The chest Computed Tomography (CT) indicated cardiac insufficiency and pulmonary edema (Figure 1).
Chest CT images of the patient 4 weeks after discharge. Compared with the findings on the 3rd day of admission, there was decreased ground-glass opacity and patchy consolidation as well as thinner bronchovascular bundle in the both lungs. The heart shadow and pericardial effusion as well as pleural effusion were also reduced.
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The CT scan of the chest indicated relieving of conditions of the heart and lung (Figure 2).
Brain MRI images of the patient 4 weeks after discharge. There were no abnormalities in the morphology of bilateral cerebral hemispheres, cerebellum and brain stem. The cerebral ventricle did not dilate and cerebral sulci or fissure did not widen. However, shadow of the mucosa of bilateral ethmoid sinus and maxillary sinus was thickened.
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The brain MRI indicated that there were no abnormalities of the brain except for the inflammation in bilateral ethmoid sinus and maxillary sinus (Figure 3).
Timeline of clinical presentations, examination and treatment of the patient since the admission to our hospital. Key results were: (1) The twin-pregnant women was admitted with fever for 3 days and one dead fetus; (2) On the 3th day of admission, the patient still had fever and presented with chest distress, breathlessness and potential septic shock; the cesarean section was performed after anti-shock therapy and one alive newborn was delivered; ampicillin-sulbactam was used since then for the potential Listeria monocytogenes infection; (3) On the 4th day, severe postpartum hemorrhage occurred and blood transfusion as well as exploratory laparotomy were conducted to stop bleeding; (4) On the 4th and 6th day of admission, Listeria monocytogenes infection was identified through culture of blood and placenta tissue, respectively; (5) On the 16th day, the placenta tissue culture found no colony formation; (6) On the 18th day, the patient was discharged; (7) On the 47th day (4 weeks after discharge), the patient was readmitted with fever. The blood culture result was negative.
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The timeline of the patient's disease course since the admission to our hospital is shown in Figure 4.