Case 292

 A seventy eight-year-old female was introduced to our hospital on September 11 for high fever of 38 ℃ and poor appetite continuing for approximately 2 weeks from a local clinic where she had been in outpatient treatment for rheumatoid arthritis. She was admitted to our hospital for suspicious sepsis. Laboratory test for two weeks after admission as follows:

 She was administered steroid pulse of 50mg/kg for a week, gradually decreasing and two weeks later exchanged prednisolone 30mg. It induced vital signs stabilized and appetite getting recovered. However, thirty days later, laboratory test on October 31 revealed elevation of inflammatory parameters, CRP 18.85 mg/dl, white blood cells 12150/mm3, neutrophils 94.5%. She received chest CT for further investigation (Figs 1, 2).

What is the imaging diagnosis on chest CT ?

1.　Viral pneumonia

2.　Fungal pneumonia

3.　Bacterial pneumonia

4.　Septic emboli

5.　Neoplasm

answer

2023.3.3