Coexistent COVID-19 pneumonia and pulmonary embolism: challenges in identifying dual pathology
| Autor: | Tanya Patrick, Jimstan Periselneris, Parthipan Sivakumar, Hastie Robbie, Katrina Abernethy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine pulmonary embolism Respiratory rate Pneumonia Viral Chest Clinic Diagnosis Differential 03 medical and health sciences Betacoronavirus 0302 clinical medicine Heart rate London Medicine Humans Sinus rhythm 030212 general & internal medicine Lung Pandemics business.industry SARS-CoV-2 COVID-19 Middle Aged medicine.disease Pulmonary embolism Pneumonia Blood pressure 030228 respiratory system Respiratory failure Anesthesia Arterial blood viral infection business Coronavirus Infections Tomography X-Ray Computed |
| Zdroj: | Thorax |
| ISSN: | 1468-3296 0040-6376 |
| DOI: | 10.1136/thoraxjnl-2020-215011 |
| Popis: | In early March 2020, a 53-year-old man was admitted to King’s College Hospital (KCH). He presented with a 2-week history of a dry cough, followed by fevers. He had a long flight 9 weeks prior to admission. His presentation to the emergency department was prompted by feeling increasingly breathless; his cough was occasionally productive of yellow sputum with streaks of haemoptysis. He had no medical history. His temperature was 38°C with peripheral oxygen saturation level of 92% on room air, respiratory rate was 28 breaths per minute but he was haemodynamically stable with blood pressure 128/75 mm Hg and heart rate 98 beats per minute. A chest X-ray on arrival showed bilateral infiltrates with denser consolidation in the right lower and upper zone. An arterial blood gas showed type 1 respiratory failure with pH 7.52, PaCO2 3.87 kPA, PaO2 8.45 kPa and lymphopenia 0.86×109/L. ECG demonstrated sinus rhythm. The patient was suspected to have viral pneumonia—likely COVID-19. He was given oxygen to target saturations 94%–98%, covered for bacterial infection as per local community-acquired pneumonia protocol and given venous thromboembolism (VTE) prophylaxis in the form of enoxaparin 40 mg once daily. Viral RT-PCR (reverse transcription polymerase chain reaction) for COVID-19 from naso-oropharyngeal and oropharyngeal swabs on both day 1 and day 2 of admission were negative. Urinary pneumococcal and legionella antigens were also negative. His D dimer was 2560 ng/mL (normal |
| Databáze: | OpenAIRE |
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