Case 2
A 56-year-old man with a recent history of surgery for lung repair and rib fracture internal fixation following a traumatic event presented to hospital with an 8-day history of intermittent fever (up to 39.1 °C, more frequent in early morning and the afternoon) accompanied by fatigue and dizziness. Cough and sputum production were absent. Laboratory testing revealed mild leukopenia (WBC count 3.33 × 109/L; reference range 3.5–9.5 × 109/L) with 75.5% neutrophils and 17.5% lymphocytes (normal range 20–40%). Inflammatory indices, including hsCRP (23.6 mg/L) and erythrocyte sedimentation rate (73 mm/h; reference range < 15 mm/h), were increased, but a search for known respiratory pathogens yielded negative findings. 18F-FDG PET/CT imaging (January 13, 2020) revealed multiple FDG-positive GGOs and consolidative opacities in both lungs (SUVmax range 1.8–7.9; Fig. 2a, b, arrows). There were also multiple FDG-avid lymph nodes in the mediastinum and the subclavian region (SUVmax range 4.1–7.0; Fig. 2c, arrows). Unfortunately, SARS-CoV-2 nucleic acid testing was not performed. The lesions on 18F-FDG PET/CT were smaller than those detected on previous CT imaging (January 7, 2020) and regressed further after treatment (January 21, 2020; Fig. 2d, arrows).
Fig. 2 Multiple FDG-positive GGOs and consolidative opacities in both lungs as well as multiple FDG-avid lymph nodes in the mediastinum and the subclavian region