Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Case Report

Pleural Effusion as a Sign of Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case Report

Author(s): Zahra Ahmadinejad, Faeze Salahshour, Omid Dadras, Hesan Rezaei and SeyedAhmad SeyedAlinaghi*

Volume 21 , Issue 3 , 2021

Published on: 09 June, 2020

Page: [468 - 472] Pages: 5

DOI: 10.2174/1871526520666200609125045

Price: $65

Abstract

Background: Recently, COVID-19 infection has become a public health concern. On March 12th, 2020, the World Health Organization (WHO) announced it as a global pandemic. Early diagnosis of atypical cases of COVID-19 infection is critical in reducing the transmission and controlling the present pandemic. In the present report, we described a patient with the chief complaints of dyspnea and dry cough referred to the oncology center at Imam Khomeini Hospital, Tehran, with the differential diagnosis of lung cancer who was diagnosed and treated for COVID-19 infection in follow up.

Case Presentation: A 59-year-old patient complained of fever, dry cough, and dyspnea from two weeks ago. The patient had been referred to this center with the differential diagnosis of lung cancer due to the massive pleural effusion in the initial chest CT scan. Dyspnea was the patient’s main complaint at the time of admission in this center and the oxygen saturation was 84%. In the new chest CT scan, similar findings were observed. Due to the severe respiratory distress, a chest tube was placed in the chest cavity to remove the pleural effusion fluid on day one. The patient’s felt relieved immediately after the procedure; however, the oxygen saturation did not rise above 85% despite the oxygen therapy. The cytology of pleural fluid was negative for malignant cells. On day 2, the lymphopenia and high level of CRP suggested the COVID-19 infection. Therefore, a control chest CT scan was conducted and the test for COVID-19 was performed. The CT report indicated the clear pattern of COVID-19’s lung involvement in the absence of pleural effusion. Thus, the treatment for COVID-19 was immediately initiated. On day 4, the test reported positive for COVID-19.

Conclusion: Currently, it is important to bear in mind the COVID-19 infection in evaluating patients with respiratory symptoms. This report indicated how misleading the presentation of a chest CT scan could be in clinical judgment. Therefore, we recommend ruling out the COVID-19 infection in all the patients with any pattern of lung involvement to avoid missing the potential cases of this vicious infection.

Keywords: COVID-19, pleural effusion, lung cancer, pneumonia, MERS.

Graphical Abstract
[1]
Shi, H.; Han, X.; Jiang, N.; Cao, Y.; Alwalid, O.; Gu, J.; Fan, Y.; Zheng, C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect. Dis., 2020, 20(4), 425-434.
[http://dx.doi.org/10.1016/S1473-3099(20)30086-4] [PMID: 32105637]
[2]
Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X.; Cheng, Z.; Yu, T.; Xia, J.; Wei, Y.; Wu, W.; Xie, X.; Yin, W.; Li, H.; Liu, M.; Xiao, Y.; Gao, H.; Guo, L.; Xie, J.; Wang, G.; Jiang, R.; Gao, Z.; Jin, Q.; Wang, J.; Cao, B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, 395(10223), 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[3]
Tsang, K.W.; Ho, P.L.; Ooi, G.C.; Yee, W.K.; Wang, T.; Chan-Yeung, M.; Lam, W.K.; Seto, W.H.; Yam, L.Y.; Cheung, T.M.; Wong, P.C.; Lam, B.; Ip, M.S.; Chan, J.; Yuen, K.Y.; Lai, K.N. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N. Engl. J. Med., 2003, 348(20), 1977-1985.
[http://dx.doi.org/10.1056/NEJMoa030666] [PMID: 12671062]
[4]
Assiri, A.; Al-Tawfiq, J.A.; Al-Rabeeah, A.A.; Al-Rabiah, F.A.; Al-Hajjar, S.; Al-Barrak, A.; Flemban, H.; Al-Nassir, W.N.; Balkhy, H.H.; Al-Hakeem, R.F.; Makhdoom, H.Q.; Zumla, A.I.; Memish, Z.A. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect. Dis., 2013, 13(9), 752-761.
[http://dx.doi.org/10.1016/S1473-3099(13)70204-4] [PMID: 23891402]
[5]
Greenhalgh, T.; Koh, G.C.H.; Car, J. Covid-19: a remote assessment in primary care. BMJ, 2020, 368, m1182.
[http://dx.doi.org/10.1136/bmj.m1182] [PMID: 32213507]
[6]
Pan, F. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology. , 2019, 200370.
[7]
Chung, M. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology., 2019, 200230.
[8]
Fang, Y. CT Manifestations of Two Cases of 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology, 2019, 200280.
[9]
Song, F. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology., 2019, 200274.

Rights & Permissions Print Export Cite as
© 2022 Bentham Science Publishers | Privacy Policy