PMC7190751_01
Chest Radiograph posteroanterior view (A) showing multifocal patchy consolidation (asterix) in bilateral lower, mid and right upper zone. Contrast Enhanced Computed tomography (CECT) of thorax coronal (B) and axial (C) with showing multiple consolidation (asterix) in bilateral lower and right middle and upper lobes with internal hypodensities suggestive of necrosis. Lung window axial sections (D) also showing similar multiple consolidations with internal air-bronchogram (black arrow).
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The chest radiograph showed (Fig. 1, A) multifocal patchy consolidation in bilateral lower, mid and right upper zone. CT of thorax was performed which revealed multiple cavitary consolidations in bilateral lung parenchyma with the largest measuring 6 x 4 cm in left lower lobe (Fig. 1, B, C, D). CT thorax also showed Centrilobular pulmonary micro-nodules noted predominantly in right upper, bilateral lower lobe.
Modified ZN-Staining: Showing Acid Fast Branching filamentous bacilli suggestive of Nocardia species.
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Sputum for modified acid-fast gram staining (1% sulphuric acid) revealed long, branching, filamentous acid-fast bacilli suggestive of Nocardia species (Fig. 2).
3A and 3B. Lacto-phenol cotton blue (LPCB) mount.. (3A). Hyaline septate hyphae with pedunculated Aleurioconidia (black arrow) suggestive of Aspergillus.. (3B). Hyaline septate hyphae, conidiophore with oval vesicle, biserriate phialide with chain of conidia.
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