PMC8383206_01
Chest and abdomen computerized tomography (CT) images. CT images obtained at Yuhuangding Hospital showing bilateral pleural effusion (A), hepatosplenomegaly (B), fluid collection around the right lower edge of the liver and multiple enlarged lymph nodes in the mesentery of the right lower edge of the liver, mesentery, and peritoneum of the middle abdomen (C,D), gallbladder enlargement, and rough and thickened gallbladder wall (E).
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F1
Abdominal CT showed fatty liver, hepatosplenomegaly, thickening of the horizontal duodenal wall, multiple enlarged lymph nodes in the mesentery, cholecystitis, and a small amount of ascites (Figure 1).
Timeline. Symptoms, diagnostic tests, and treatment. A, anorexia; B, intermittent bloody stools; D, intermittent diarrhea; CT, computed tomography; MRCP, magnetic resonance cholangiopancreatography; P, S. Typhi was isolated by blood culture; CLI, clindamycin 600 mg on day 1, 300 mg on day 2; ETI, etimicin 100 mg; DXM, dexamethasone 5 mg; ANI, anisodamine 10 mg; ATD, antondine 2 ml; LEV, levofloxacin 0.5 g/day; IPM, imipenem; MEM, meropenem 1 g/8 h; LPZ, lansoprazole 60 mg; OME, omeprazole 40 mg iv bid initially and then 40 mg iv qd; CSS, cefoperazone and sulbactam sodium 2 g/8 h; HA, hemocoagulase agkistrodon 2 IU iv; K1, vitamin K1 20 mg ivgtt; NE, norepinephrine 400 mug/h; OCT, octreotide 8 mug/h; SST, somatostatin 250 mug/h; HPC, human prothrombin complex 600 IU ivgtt; BT, blood transfusions 3.5 units on day 11, 12 units on day 12, and 4 units on day 16; OA, ornithine aspartate for injection 5 g; MIZ, magnesium isoglycyrrhizinate 150 mg/day during the first 4 days and then 100 mg/day; ESL, etamsylate 0.5 g/day; AMA, aminomethylbenzoic acid 0.1 g/day; GSF: recombinant human granulocyte stimulating factor 100 mug subcutaneous injection; TAE, transcatheter arterial embolization; CAZ, ceftazidime.
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F2
Hemostasis was achieved and the patient continued to receive total parenteral nutrition and symptomatic support treatment (Figure 2).