ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
Aspergillosis superinfections have been reported as acute complications of COVID‐19. We report a rare case of combined chronic necrotizing pulmonary aspergillosis, aspergilloma, and fibrosing aspergillosis in a 31‐year‐old woman with a history of COVID‐19. Chest scan remains an important imaging method assisting in the diagnosis and management of post‐COVID‐19 patients. Chronic pulmonary aspergillosis is a potentially serious disease that may threaten the post‐COVID‐19 patient's vital and functional prognosis. Yet, both the diagnosis and the treatment are challenging. Therefore, early clinical suspicion, chest CT scan, and screening for aspergillosis are important. Next, timely antifungal treatment based on international guidelines is recommended.