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