COVID-19: case 57

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Priotto Roberto, Negri Alberto, Demaria Paolo, Baralis Ilaria,  Cerutti Andrea, Violino Paolo

S.C.  Radiodiagnostica – A.O. “S. Croce e Carle” – Cuneo

40-year-old male patient with dyspnea and fever for 10 days not responding to antibiotics to the ED on March 13, 2020. Prior medical history: previous pneumonia, smoker. Epidemiologic risk for SARS-CoV-2 (the patient returned home from Milan (high-risk area) on March 5).

Fever (T 40 °C), dyspnea, no bronchial secretion, wheezing.

PaO2 63,4 mmHg, pH 7,5, pCO2 35 mmHg. C-RP 87,16 mg/L, Fibrinogen: 621 mg/dL, Procalcitonin: 0,16 ng/ml, LDH: 328 U/L

Chest Radiography:

bilateral blurred pulmonary consolidations, mainly at the right base (suspected for SARS COV 2). Other ill-defined consolidations at the right base. 

HRCT, March 4, 2020:

Multiple scattered “ground-glass” opacities with predominant subpleural distribution involving all lobes, findings consistent with Covid 19 pneumonia. No pleural effusion. In the anterior segment of the RUL a 10 cm lung thin-wall cyst is noted.

RT-PCR on a nasopharyngeal swab was positive for SARS-CoV-2. The patient was hospitalized in the infectious disease department and started the Covid-19 treatment protocol.