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COVID-19 pneumonia

Case contributed by Dr Roma Patel

Presentation

Four-day history of dry cough, myalgia, pyrexia and sore throat. Admitted to hospital for worsening dyspnea. No past medical history.

Patient Data

Age: 35 years
Gender: Female
X-ray

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. 

X-ray

Two days later

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.

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Case information

rID: 75415
Published: 27th Mar 2020
Last edited: 1st Apr 2020
System: Chest
Inclusion in quiz mode: Included

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