Can you make the Dx?
A few potential organisms come to mind, including:
Group A streptococcus
The water bottle sign in this patient suggests a large pericardial effusion.
The radiographic findings in patients with candidiasis/candidemia and group A streptococcus are non-specific. In contrast, findings in patients with Coxsackievirus B infections generally include consolidation, nodularity, and effusions.
The radiographic findings in patients with Staphylococcus aureus include consolidation and interstitial lung disease.
While pericardial effusions most often have a viral etiology, hemorrhagic pericarditis is most often associated with tuberculosis or a malignancy. M. tuberculosis is the most likely culprit organism in this patient.
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