PMC9548583_01
Skin congestion and swelling on the left calf (A) on admission, and right chest wall (B) 5 days after admission.
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F1
The skin over his left calf was congestive and swollen with tenderness (Figure 1A). However, the patient's condition kept deteriorating with persistent fever, skin lesion expanding (Figure 1B), rhabdomyolysis and subsequently acute respiratory distress syndrome.
Chest CT on admission revealed patchy shadows and consolidations in both lungs and pleural effusion bilaterally. Presumed abscess in the right lower lobe (white fine arrow) and cavitation in the left upper lobe (red thick arrow) were noted.
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F2
Presumed abscess in the right lower lobe and cavitation in the left upper lobe were noted as well (Figure 2).
Timeline of the patient with disseminated Legionnaires' disease. The patient was transferred into MICU on May 12, 2021, which was ICU Day 0. Major events during the course of the patient's illness are indicated in the graph. The upper graph shows the body-temperature curve (blue line). Laboratory values obtained and primary medications administered during the patient's ICU hospitalization are shown below. HFNC denotes high-flow nasal cannula, MICU medical intensive care unit, RA room air, mNGS metagenome Next-Generation Sequencing.
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F3
He was extubated on MICU day 9 and was transferred to general ward on MICU day 12 (Figure 3).