Open AccessPulmonary embolism in COVID-19 pneumonia: An overlapping diagnosis or a misdiagnosis?
Author(s) -
Eleonora Secco,
Maria Cristina Pasqualetto,
Fausto Rigo
Publication year - 2020
Publication title -
journal of cardiovascular echography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 8
eISSN - 2347-193X
pISSN - 2211-4122
DOI - 10.4103/jcecho.jcecho_43_20
Subject(s) - medicine , pneumonia , hydroxychloroquine , pulmonary embolism , azithromycin , emergency department , chest pain , covid-19 , viral pneumonia , intensive care medicine , radiology , disease , infectious disease (medical specialty) , psychiatry , microbiology and biotechnology , biology , antibiotics
Coronavirus pneumonia (COVID-19) is a novel infectious disease with a high mortality rate due to severe acute respiratory syndrome. A 57-year-old woman was admitted to the emergency department (ED) with fever, cough, atypical chest pain, and dyspnea. She remained in the ED for about 48 h while waiting for the result of the COVID-19 oropharyngeal swab. Once she tested positive, she was hospitalized in the pneumological department with a diagnosis of pneumonia based on a chest X-ray and biochemical tests. Although azithromycin and hydroxychloroquine were promptly administered, she had a worsening of dyspnea even with a high-flow oxygen mask. D-dimer was increased, and a computed tomography scan with pulmonary and leg angiogram was positive for bilateral pulmonary embolism, deep-venous thrombosis, and multiple consolidated opacities in the lung parenchyma. This case highlights the fact that, in a pandemic situation, there is a potentially fatal risk of overlooking an alternative diagnosis in a COVID-19 patient who is generally considered as suffering only from pneumonia.