What kind of miraculous infection is caused by multiple lumps in both lungs?

*Only for medical professionals to read and reference.
The initial treatment should be standardized, combined with clinical comprehensive analysis, and the initial treatment should not be made different based on feelings.
Foreword In clinical practice, we often encounter some very magical cases and very distinctive CT images.

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We always feel that this very distinctive CT should highly suggest a certain disease, but we just don’t know what disease it is
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Does the CT below feel familiar? It feels very distinctive.
I should be able to tell what disease it is from imaging studies, but I just don’t know
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Figure 1 What should I do when encountering such a distinctive CT? Today, I would like to share with you a magic weapon that everyone knows but will never use and is very useful
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1.
Case introduction: Middle-aged female with fever, cough, and yellowish sputum for 3 days
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Moderate fever, body temperature around 38 degrees, fever at night, less sputum, no hemoptysis, dyspnea, chest pain, no obvious fatigue, etc.
, no arthralgia, skin rash
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Past history: Normally healthy, without using hormones indiscriminately
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Physical examination: Normal condition is good, no shortness of breath, a small amount of wet rales in both lungs, nothing special
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Auxiliary examination: blood test showed white blood cells 14×109/L, neutral 55%, hemoglobin 157g/L, platelets 367×109/L
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The chest CT is as follows: Figure 2-11 2.
Case analysis At first glance, is this case and CT very distinctive? There are multiple mass-like lesions in both lungs, partly distributed along the bronchial vascular bundle! Is it a miraculous disease? Blood-borne Staphylococcus aureus pneumonia? The lesions of this disease are mainly distributed under the pleura, which is common in the elderly and infirm.
The patients are usually healthy and do not use drugs that cause the decline of resistance.
The distribution of the lesions is not mainly distributed under the pleura, and it is not supported
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Fungal pneumonia? The patient is usually in good health and has not used drugs that would reduce the resistance.
This is currently not considered
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Lung cancer? Lung cancer generally has mild symptoms, slow onset, and slow development.
The patient has fever, cough, and yellowish sputum for 3 days.
The onset is rapid, unlike the onset of lung cancer
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tuberculosis? Pulmonary tuberculosis also generally has a slow onset, and the shape of the lesion is diverse.
The shape of the CT lesion of the patient is single, which is not supported
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Vasculitis? It is possible, but vasculitis is a rare disease, and often manifests as multi-system damage.
The patient does not have the performance of multi-system damage, so it is not supported
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Cryptogenic organizing pneumonia? It is possible, but the disease is rare, and initial treatment is generally not considered
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To sum up, the patient is usually healthy and does not use drugs that can reduce the resistance.
First of all, the fungus is not considered.
The patient has a fever with cough and yellow pus sputum for 3 days.
The white blood cell is significantly increased, and the lungs have multiple masses.
Not a common manifestation of bacterial pneumonia
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However, in a comprehensive analysis, first consider the common disease: community-acquired pneumonia
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Treatment: Piperacillin and Tazobactam anti-infective treatment
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3.
Outcome After the anti-infective treatment of piperacillin and tazobactam, the body temperature dropped quickly.
After 12 days of treatment, the miraculous lesions in both lungs were absorbed quickly! Figure 12-16 This seemingly magical lung CT is a proper bacterial pneumonia! Although the patient’s lungs are full of lesions, the patient’s symptoms are mild, there is no respiratory failure, no hypotension, no multiple organ dysfunction, severe pneumonia cannot be diagnosed, but a very common lobular pneumonia
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Postscript: When we face the patient’s magical lung CT, we must first combine the clinical comprehensive analysis.
If the patient is in general condition, the initial treatment should be standardized.
Don't get a lot of drugs at the beginning of the treatment
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The initial treatment should be standardized, combined with a comprehensive clinical analysis, and the initial treatment should not be made different based on feelings
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