Presentation
Acute cough, shortness of breath and fever for one 10 days.
Patient Data
There are multifocal, confluent, bilateral and peripheral, ground glass opacities combined with septal thickening (crazy paving pattern) in both lungs.
Well opacification of the heart, pulmonary trunk, pulmonary arteries to lobar and segmental branches without any filling defect to suggest pulmonary thrombo-embolism.
No pleural effusion or pneumothorax in the either side.
No evidence of mediastinal or hilar lymphadenopathy.
Trachea and esophagus appear normal in wall thickness.
multifocal hazy opacities in peripheries of right middle and both lower zones.
Mediastinum is centered and is of normal width.
The trachea shows a normal position, borders, and diameter.
Both hila are of normal size, shape, position.
The cardiac and vascular shadows show a normal configuration.
The diaphragm has smooth contour, normal arched shape and occupies normal position.
The costo-phrenic angles are clear bilaterally.
Case Discussion
The x-ray features can be subtle but CT features are striking and diagnostic of COVID-19 pneumonia.
The PCR exam was positive of COVID-19 (COVID-19 virus RNA detected).
WBC: 8000 (normal range: 4000-8000)
Neutrophils: 86.6 % (normal range: 40-75%)
ESR: 50 (normal range: 0-15)
CRP: 7.5 (normal range 0-1)