Fig. 3

Clinical information of Case 2 from hematopoietic cell transplantation (HCT) to death. a The clinical course from HCT to admission. b The clinical course during the last hospitalization. c-e Images of the non-enhanced chest CT scans. c Mild chronic inflammation in the anterior basal segment of the lower lobe of both lungs and the external basal segment of the right inferior lobe. Multiple solid and ground-glass small nodules opacity were seen, with the lower lobe of both lungs as the most severe sites. d Systemic inflammation in both lungs, similar to c. e Systemic inflammation in both lungs characterized by multiple nodular, patchy, and solid plaque or ground-glass opacity, more advanced compared to e. f-i The bone marrow smear results before and after admission. f, g Active bone marrow proliferation, with a granulocyte to erythrocyte ratio of 0.73:1. Toxic granules were found in mature granulocytes, and platelets were rarely seen. h, i Suppressed bone marrow proliferation, with a granulocyte to erythrocyte ratio of 1.22:1. Megakaryocytes were not seen, and platelets were rarely seen. BALF, bronchoalveolar lavage fluid; BKPyV, BK Polyomavirus; CMV, cytomegalovirus; CRP, c reactive protein; CRRT, continuous renal replacement therapy; G-CSF, granulocyte colony-stimulating factor; HGB, hemoglobin; mNGS, metagenomic next-generation sequencing; NEU, neutrophil count; PCT, procalcitonin; PLT, platelet count; PPI, proton pump inhibitors; SCR, serum creatinine; VZV, varicella-zoster virus; WBC, white blood cell counts