Silvia Lucarini, Chiara Moroni, Antonella Masserelli, Edoardo Cavigli, Lina Bartolini, Alessandra Bindi, Silvia Pradella AOU Careggi, Firenze, Direttore Dr. Vittorio Miele.
61-years-old male patient admitted to the ED for severe dyspnea, confusion on March 3. Bedfast after a recent upper respiratory infection. Medical history: DM type 2, HTA. Non-smoker.
Blood test: WBC 11.2; C-PR 301 (normal values < 5); LDH 738 (normal values 135-225); Fibrinogen 798 (normal values 200-400); INR 1.4. ABG: PaO2 82; PCO2 32.
A CTA was performed for suspected pulmonary embolism:
Multiple aree di ground-glass estese diffusamente in entrambi i polmoni con inizali aspetti consolidativi nelle regioni basali ove si evidenzia risparmio subpleurico; coesiste moderata riduzione volumetrica di entrambi i polmoni.
Multiple and diffuse ground-glass opacities involving both lungs, associated with consolidations at the bases, those sparing the cortex. Lungs volume is also reduced.
The patient was promptly intubated and a treatment with Lopinavir-Ritonavir and Cloroquine was also started.
Chest film after intubation (March 3):
Chest film on March 6:
comparing to the previous CRX, an improvement of the pulmonary involvement is seen.
On March 12, a chest radiography was required due an increase of the procalcitonin levels (1.96, normal values <0.5):
A new-onset consolidation in the left base is noted, finding suspected for bacterial superimposed infection.
Antibiotics are then introduced along with redemsivir.