Presentation
Four-day history of dry cough, myalgia, pyrexia and sore throat. Admitted to hospital for worsening dyspnea. No past medical history.
Patient Data
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First chest radiograph on admission demonstrates multiple patchy areas of peripheral air space opacification considered typical for COVID 19 with the appropriate history. No pleural effusions.
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Limited inspiratory effort, with radiological progression showing peri-hilar and peripheral areas of consolidation and new areas of interstitial thickening.
Case Discussion
On admission, RT-PCR was positive for COVID-19.
This case demonstrates that young patients with no past medical history are also at risk of deterioration and patient demographics should not provide a false sense of reassurance.
Patchy peripheral areas of air space opacification are considered typical for COVID-19, hence, correlation with PCR is advised with no indication for a chest CT in the first instance.
The pattern of progression demonstrated from initial air space opacification to interstitial thickening and consolidation have been previously recognized to occur between days 4-12 from symptomatic onset.
Appropriate isolation should be advised on reports for all chest radiographs concerning for COVID-19.