European journal of case reports in internal medicine
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Eur J Case Rep Intern Med · Jan 2020
False-Negative Nasopharyngeal Swab RT-PCR Assays in Typical COVID-19: Role of Ultra-low-dose Chest CT and Bronchoscopy in Diagnosis.
On 11 March 2020, the WHO declared COVID-19 a pandemic and global health emergency. We describe the clinical features and role of ultra-low-dose chest computed tomography (CT) and bronchoscopy in the diagnosis of coronavirus disease (COVID-19). In our patient, who was highly suggestive clinically and radiologically for COVID-19, we had two false-negative results for nasopharyngeal and oral swab reverse-transcriptase polymerase chain reaction (RT-PCR) assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eventually, we confirmed the diagnosis using bronchoscopy and bronchoalveolar lavage (BAL).
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Eur J Case Rep Intern Med · Jan 2020
Pericardial Fluid in a COVID-19 Patient: Is It Exudate or Transudate?
Very limited information is available on pericardial effusion as a complication of COVID-19 infection. There are no reports regarding pericardial fluid findings in COVID-19 patients. ⋯ We believe this is the first such reported case. Findings suggested the fluid was exudative, with remarkably high lactate dehydrogenase and albumin levels. We hope our data provide additional insight into the diagnosis and therapeutic options for managing this infection.LEARNING POINTS: Laboratory findings of drained pericardial fluid in a patient with COVID-19 are presented.The clinical presentation of pericardial involvement in COVID-19 infection and the role of echocardiography in diagnosis and management are described.
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Eur J Case Rep Intern Med · Jan 2020
Effectiveness of Tocilizumab in a COVID-19 Patient with Cytokine Release Syndrome.
Cytokine release syndrome (CRS) is a systemic inflammatory response that can be triggered by many factors such as infections. CRS in patients with coronavirus disease 2019 (COVID-19) is life-threatening and can occur very rapidly after COVID-19 diagnosis. Tocilizumab (TCZ), an interleukin-6 (IL-6) inhibitor, may ameliorate the CRS associated with severe COVID-19 and thus improve clinical outcomes. We present a case of life-threatening CRS caused by COVID-19 infection successfully treated with TCZ.
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Severe COVID-19 may predispose to both venous and arterial thrombosis. We describe a patient with acute ischaemic stroke while suffering from COVID-19 and respiratory failure, necessitating mechanical ventilation. Deep sedation may delay diagnosis.
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Eur J Case Rep Intern Med · Jan 2020
Cerebral Venous Sinus Thrombosis as a Presentation of COVID-19.
Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe the case of a 59-year-old man who presented with headache, hypertension and a single episode of fever with no other symptoms. ⋯ A subsequent test for COVID-19 was positive. This is the first report of CVST as a presenting symptom of COVID-19 infection.