Diagnostic challenge of dyspnea in the context of the COVID-19 pandemic wave: a case report.

Autor: Razafindrasoa ZA; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar., Razafimpihanina SM; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar., Rasoafaranirina MO; Centre Hospitalier Universitaire Tambohobe, Fianarantsoa, Madagascar., Martin FA; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar., Andriamahenina FPP; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar., Andriarimanga DO; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar., Rakotomizao JR; Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar., Tiaray HM; Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar., Rakotoson JL; Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar., Raharimanana RN; Centre Hospitalier Universitaire Fenoarivo, Antananarivo, Madagascar.
Jazyk: angličtina
Zdroj: The Egyptian journal of internal medicine [Egypt J Intern Med] 2023; Vol. 35 (1), pp. 9. Date of Electronic Publication: 2023 Jan 31.
DOI: 10.1186/s43162-023-00192-6
Abstrakt: Background: Since its discovery, COVID-19 has often been the first diagnosis of dyspnea and asthenia, especially during the pandemic waves. However, it is not always COVID-19. We report a particular case of a late-diagnosed HIV-positive patient in Madagascar.
Case Presentation: A 21-year-old male patient was admitted to a hospital center in Antananarivo for dyspnea and poor general condition. Physical examination revealed hypoxemia of 85% on room air. His chest X-ray showed bilateral reticular-micronodular opacities. He was suspected and treated for COVID-19. On the 15th day of hospitalization, HIV-1 infection complicated by probable pneumocystis was diagnosed. On the other hand, a multimetastatic testicular cancer was also suspected. The patient died after a few hours of hospitalization in the intensive care unit.
Conclusion: This was a case of an HIV-positive patient belatedly diagnosed in the complications stage during the COVID-19 pandemic wave. The investigation of the differential diagnoses remains crucial to avoid serial misdiagnosis and to adjust therapeutic management.
Competing Interests: Competing interestsThe authors declare that they have no competing interests.
(© The Author(s) 2023.)
Databáze: MEDLINE
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