Table 1. Relevant Investigations

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Presentation transcript:

Table 1. Relevant Investigations Result Reference White cell (on admission) 5.5 x 109/L 3.6-9.3 x 109/L Haemoglobin (on admission) 12.9 g/dL 11-15 g/dL Platelet (on admission) 196 x 109/L 170-420 x 109/L C-reactive protein (on admission) 320 mg/L 0-5 mg/L HIV screen Negative HbA1c 5.7% Ideal 4.5-6.4% Sputum acid fast bacillus stain (AFB) x 4 sets Sputum Mycobacterium tuberculosis PCR Blood culture on admission x 2 sets No growth Blood culture on day 4 of admission x 2 sets Urine Legionella antigen Urine Streptococcus pneumoniae antigen Influenza PCR Sputum Gram stain Predominant organism not seen Nasal swab respiratory viruses multiplex PCR Burkholderia pseudomallei antibody Indirect haemagglutination assay (IHA) titre 1:16 Positive Bronchial washing 1) Gram stain No predominant organism 2) Culture Normal flora of the upper respiratory tract 3) Microscopy No Nocardia isolated after prolonged incubation 308 nucleated cells/uL 85% neutrophils 4% lymphocytes 1% monocytes 1% eosinophils 9% macrophages 4) Aspergillus galactomannan test 5) Fungus smear and culture 6) Cytology No malignant cells 7) Gomoris Methenamine-Silver Nitrate stain for Pneumocystis jiroveci 8) Acid fast bacillus stain 9) M. tuberculosis PCR Bronchoscopy Vocal cords normal. White cheesy plaques seen in trachea and left main bronchus. Consider fungal infections. Purulent secretions from left upper lobe seen. No significant secretions in right bronchial tree Computed tomography of chest 1. Extensive consolidation, peribronchial cuffing and centrilobular nodularity is seen in the left lung, in keeping with the submitted history of infection. Similar, milder infective changes are seen in the right lung. 2. A small left parapneumonic effusion is seen. 3. Reactive mediastinal and hilar lymphadenopathy are noted Computed tomography pulmonary angiogram There is no pulmonary embolism Ultrasonography of abdomen No collection or abscess Chaozer Er et al. Mycoplasma Pneumoniae, an Important Differential Diagnosis of Non-Responding Pneumonia. American Journal of Medical Case Reports, 2017, Vol. 5, No. 1, 15-21. doi:10.12691/ajmcr-5-1-5 © The Author(s) 2015. Published by Science and Education Publishing.