Open AccessDyspnea is a Conundrum in the COVID-19 Era - A Case Report
Author(s) -
Nithya Rajendran,
Ruth Cusack,
Keneilwe Malomo,
Joseph Browne,
Ontefetse Ntlholang
Publication year - 2017
Publication title -
clinical case reports international
Language(s) - English
Resource type - Journals
ISSN - 2638-4558
DOI - 10.25107/2638-4558-v5-id1233
Subject(s) - medicine , exacerbation , covid-19 , pneumonia , intensive care medicine , organizing pneumonia , cytokine storm , pneumonitis , lung infection , lung , disease , infectious disease (medical specialty)
Background: In the COVID-19 era, a simple dyspnea can raise diagnostic uncertainties especially when presented with patients with underlying interstitial lung disease or congestive cardiac failure which can both present clinically and radiologically similar to COVID-19 pneumonitis. Moreover, such co-morbidities have an increasingly poorer outcome when associated with SARS-CoV-2 infection. Case Report: An 85-year-old lady presented with dyspnea a week after being treating for chest infection by general practitioner. Chest X-rays and CTPA showed bilateral airspace opacifications with organizing pattern and SARS-CoV-2 was not detected on three PCR swabs. She was managed with diuretics, antimicrobials, steroids, oxygen and non-invasive ventilation. Conclusion: An acute exacerbation of ILD, decompensated CCF and CT findings of an organizing pneumonia pattern, raises the possibility of previous SARS-CoV-2 infection being the trigger for the patient’s presentation. Nasal swabs only detect viral shedding, but not the pending cytokine storm thereby posing diagnostical difficulties.