Presentation
Recent onset of dry cough, severe dyspnea, fever and fatigue.
Patient Data
Age: 85 years
Gender: Male
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Findings:
Quality: no artefacts
coronary sclerosis, mild aortic sclerosis
no significant mediastinal lymphadenopathy
Pulmonary findings:
- extensive patchy bilateral multi-lobar ground-glass opacities (GGO)
- predominantly peripheral distribution in the left lung, peripheral and central distribution in the right lung
- partial consolidations along the bronchovasular bundles surrounded by ground-glass opacities (GGO)
- superimposed inter-and intralobular septal thickening (crazy-paving pattern) in the right lower lobe
- bilateral vascular dilatation
Additional findings:
- pulmonary nodule (18mm) in the anteromedial segment of the left lower lobe
- no pleural effusions
Impression:
Findings are compatible with atypical pneumonia.
In view of the patient's symptoms and the current COVID-19 pandemic, this is indicative of COVID-19 pneumonia.
From the case:
COVID-19 pneumonia
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Key findings:
- extensive ground-glass opacities (GGO) with bilateral and multi-lobar distribution
- crazy paving pattern (red arrows)
- combination of consolidations and surrounding ground-glass opacities also referred to as "Halo sign" (blue arrows)
- vascular dilatation (green arrows)
- fibrous bands or streaks (yellow arrow)
- air bronchogram (orange arrows)
Case Discussion
This case illustrates a spectrum of findings in COVID-19 pneumonia:
- extensive ground-glass opacities (GGO)
- bilateral and multi-lobar distribution
- crazy-paving pattern
- combination of ground-glass opacities and consolidation
Real-time polymerase chain reaction (PCR) after pharyngeal swab was positive for SARS-CoV-2 virus RNA.
The patient has been put under isolation and referred to the intensive care unit (ICU).
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