ABSTRACT
Background: COVID-19 is known to induce a wide range of symptoms, most likely as a result of fast respiratory deterioration, which leads to rapid decompensation of the patient's clinical condition. Surprisingly, some patients have both the novel virus and a secondary bacterial infection, which makes disease management even more difficult. Case report: We reported a case of a patient with a positive polymerase chain reaction (PCR) test for SARS-CoV-2 presenting a rapidly worsening dinical course due to superimposed pneumonia diagnosed by laboratory markers and radiologic findings. The first Chest X-ray revealed a voluminous dense homogenous mass located in the middle lobe of the right lung and scattered alveolar opacities in the left lung field. Non-enhanced chest computed tomography (CT) scanner showed nonspecific imaging features of COVID-19 pneumonia by consolidation with multifocal, diffuse, perihilar ground-glass opacities. Repeated chest X-ray showed this mass on the right is larger and more prominent of the alveolar opacities scattered across the two lung fields. Conclusion: CT findings are critical in assisting radiologists in quickly recognizing the characteristics of pulmonary lesions and their consequences. One of the imaging findings consistent with lung super infection consequences is the advancement of consolidation and multifocal nodular opacities, which presents the clinical symptom and laboratory testing required in these individuals.